[Exercise-induced coronary artery spasm. Angiographic demonstration and results of medical treatment].
This report describes a case of a patient with a history of classical angina of effort which developed into an unstable progressive syndrome. A 42-year-old-woman was admitted to the hospital because of resting angina pectoris. Examination revealed signs of septal subepicardial ischemia in the resting electrocardiogram and a positive ergometric test with marked depression of the S-T segment. Hemodynamic studies showed in the ventriculogram a clearly defined area of hypokinesis on the anterolateral segment of the ventricle and the coronariography revealed normal vessels. During exercise the patient developed anginal pain and an elevation of the S-T segment in a lead II electrocardiogram. During the pain episode, selective left and right coronariographies showed the presence of a severe spasm in the first portion of the anterior descending branch. In the course of one of the injections the patient developed ventricular fibrillation, this was reverted with a 400 watts/sec shock. The patient was discharged from the hospital a few days after and has been successfully treated with nitrates and calcium blocking agents. This case represents the first time that a coronary spasm in normal vessels has been adequately documented by us.
D000328:Adult; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005080:Exercise Test; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage; D009543:Nifedipine / Q000008:administration & dosage
D009543:Nifedipine; D007548:Isosorbide Dinitrate
Espasmo arterial coronario inducido por ejercicio. Demostracíon angiográfica y resultados del tratamiento médico.