title: 'Variant' angina: evidence for small vessel coronary artery spasm?
abstract: A unique case of 'variant' angina pectoris has been observed in a patient with normal coronary arteries and typical chest pain appearing spontaneously at rest, and repeatedly provoked by ergonovine maleate (0.1 mg iv) associated with large transmural perfusion defects on 201Tl-imaging (after ergonovine) and a marked increase in T wave voltage despite no demonstrable spasm of a major coronary artery after the same doses of ergonovine. While saline solution could not provoke chest pain and treatment with a beta-blocking agent increased the frequency of ischemic attacks, a calcium antagonist therapy reduced and eventually eliminated the attacks. Thus, this case provides evidence for yet another aspect of a 'variant' form of angina pectoris: small vessel coronary artery spasm.
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000503:physiopathology*; D000788:Angina Pectoris, Variant / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology*; D004562:Electrocardiography; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging