[Immediate collateral coronary circulation after a methylergometrin test].
The development of a collateral coronary circulation has been well studied by angiography in two main clinical situations: myocardial infarction (by durable coronary occlusion) and angina (due to significant coronary artery stenosis), but only rarely in spastic angina. The authors report the case of severe spasm at the site of non-significant stenosis after a methylergometrine test, with immediate contro-lateral collateral circulation in a patient with a short history of spastic angina without myocardial infarction. This observation demonstrates that collateral circulation may develop very rapidly in spastic angina (without basal ischaemia in the absence of significant coronary stenosis), because this patient only had seven ten-minute episodes of clinical ischaemia. As collateral circulation may mask clinical and electrical signs in spastic angina, this case suggests that angiographic control should be systematic during the methylergometrine test.
Jacq
L
L
Service de cardiologie, hôpital Gillesde-Corbeil, Corbeil-Essonnes.
Caussin
C
C
Pezzano
M
M
Verdaguer
M
M
Lardoux
H
H
D003097:Collateral Circulation / Q000187:drug effects*; D003326:Coronary Circulation / Q000187:drug effects*; D003327:Coronary Disease / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008755:Methylergonovine / Q000494:pharmacology; D008875:Middle Aged; D010120:Oxytocics / Q000494:pharmacology
D010120:Oxytocics; D008755:Methylergonovine