title: Angiographic demonstration of different pathogenetic mechanisms in patients with spontaneous and exertional angina associated with S-T segment depression.
abstract: Three patients complained of spontaneous and exertional chest pain, both associated with S-T segment depression in anterior electrocardiographic leads. In each, coronary spasm was demonstrated on coronary arteriography during a spontaneous attack of pain. Coronary arteriograms taken during exercise-induced angina did not show evidence of spastic obstruction; this suggests that exercise-induced chest pain and S-T segment depression were secondary to the increase in oxygen requirements rather than to a sudden decrease in coronary blood flow. Thus, two pathogenetic mechanisms coexisting in the same patient may cause chest pain associated with subendocardial ischemia.
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000209:etiology; D001783:Blood Flow Velocity; D003331:Coronary Vessels / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors