title: Reversible ischemia on treadmill exercise in left main coronary artery vasospasm.
abstract: Coronary vasospasm of the left main coronary artery (LMCA) is a rare condition with potentially devastating consequences. We present 2 patients with LMCA vasospasm-related angina, the first being a 46-year-old woman and the second a 51-year-old woman. Both of them developed ST-segment ischemic changes on treadmill exercise tests. Coronary angiography showed spontaneous LMCA vasospasm in one patient and methylergonovine-induced LMCA vasospasm in the other patient. Follow-up treadmill exercise tests revealed no exercise-induced ischemia after calcium antagonist monotherapy. These cases demonstrate the importance of identifying LMCA vasospasm, as the treatment of choice varies in patients with angina pectoris. Reversible myocardial ischemia caused by LMCA vasospastic angina can be controlled by calcium antagonist monotherapy and detected by repeat non-invasive stress testing.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei 235, Taiwan, China.
authors.forename: Ming-Yow
authors.initials: MY
authors.lastname: Hung
authors.forename: Nen-Chung
authors.initials: NC
authors.lastname: Chang
authors.forename: Ming-Jui
authors.initials: MJ
authors.lastname: Hung
mesh_terms: D003329:Coronary Vasospasm / Q000175:diagnosis* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology