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Results for “Angina Pectoris, Variant”

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At least 37 records · Page 2Linked to original sources
PubMed1970

Continuous electrocardiographic recording in Prinzmetal's variant angina pectoris. A report of four cases.

Four patients with Prinzmetal's variant angina pectoris were subjected to continuous electrocardiographic recording. In three of them several episodes of ST segment elevation unaccompanied by pain were recorded. In one patient, identical electrocardiographic alterations were observed both in presence or in absence of pain, while in the others a good correlation was evident between pain and severity of the electrocardiographic abnormalities. In two patients transmural myocardial infarction complicated the course of the angina. In contrast to the classical findings, in these patients the attacks of chest pain did not cease after the infarction, but became more frequent and severe. The electrocardiographic alterations of the anginal episodes occurred in the same myocardial areas involved by the infarction, so that a reversible superposition of electrocardiographic signs of acute ischaemia on those of recent necrosis was observed. Continuous electrocardiographic recording provided the best means of investigation of these patients with the variant form of angina pectoris.

Adult↗
PubMed1984

Ischaemia related ventricular arrhythmias in patients with variant angina pectoris.

UNLABELLED: Twenty-three patients with variant angina were studied by Holter monitoring both to assess the incidence of serious ventricular arrhythmias (a risk factor of sudden death in variant angina), during ischaemic episodes and to examine the time-relation of the arrhythmias to ST changes. Serious ventricular arrhythmias were observed in 12/23 patients (52%). In the 23 patients, a total of 491 episodes of ST segment elevation were recorded during 954 h of Holter monitoring; serious ventricular arrhythmias were found in only 46 ischaemic episodes (9.4%). Six out of 12 patients showed serious ventricular arrhythmias at the onset of ischaemic episodes or during maximal ST elevation (phase 1), one patient during return or immediately after return of ST to baseline (phase 2) and five patients during both phases. Thirty-three out of 46 ischaemic episodes (76%) showed serious ventricular arrhythmias during phase 1, eight (17%) during phase 2, and five (11%) during both phases. Serious ventricular arrhythmias were neither related to previous myocardial infarction nor to the presence of serious ventricular arrhythmias during inter-crisis periods, whereas a good relationship with severity of ischaemic episodes, as assessed by the magnitude and duration of ST elevation, was found. A modest relationship with anterior ST elevation was also found. IN CONCLUSION: (1) serious ventricular arrhythmias occur in a high percentage of variant angina patients, but in only a small proportion of ischaemic episodes; (2) serious ventricular arrhythmias are related to the severity of ischaemia and occur predominantly at the onset of ischaemic episodes and/or during maximal ST elevation; in only a few cases do they occur during resolution of ischaemic episodes.

Adult↗
PubMed2005

[Variant angina pectoris associated with Morgagni-Adams-Stokes syndrome--case report].

We report a case of Prinzmetal angina initially manifested with short losses of consciousness in a 55-year-old man hospitalized in the Department of Coronary Artery Disease, Institute of Cardiology, Jagiellonian University Medical College in Cracow. Clinical symptomatology of the presented case, causes and mechanism of loss of consciousness in variant angina as well as treatment methods are discussed.

Adams-Stokes Syndrome↗
PubMed1985

Different susceptibility to myocardial ischemia provoked by hyperventilation and cold pressor test in exertional and variant angina pectoris.

Coronary constriction at the site of atherosclerotic stenoses has been suggested to play an important role in modulating the frequency of symptoms in patients with exertional angina. To investigate whether stimuli triggering coronary constriction have similar effects in patients with exertional and variant angina, responses to hyperventilation (HV) and cold pressor test (CPT) were evaluated. Twenty patients with chronic exertional angina, positive exercise test results and coronary heart disease were compared with 14 patients with variant angina and ST-segment elevation during an ergonovine test. In patients with exertional angina, the CPT produced diagnostic ST-segment depression in 6 of 20 patients (30%) at levels of rate-pressure product much lower than those during the exercise test; all patients had low effort tolerance and severe coronary artery disease. HV produced diagnostic ST-segment depression in only 1 of 20 patients (5%) (p less than 0.05 compared to that with CPT). Conversely, in patients with variant angina, HV produced ST-segment elevation in 11 of 14 patients (78%) and CPT produced elevation in only 2 of 14 (14%) (p less than 0.01). Thus, coronary constriction can provoke myocardial ischemia not only in patients with variant angina but also in some patients with exertional angina. Furthermore, the 2 groups of patients have a different susceptibility to stimuli known to produce coronary constriction.

Adult↗
PubMedDate not supplied

[Variant angina pectoris with demonstration of coronary spasm. Diagnostic and therapeutic considerations].

Eight patients with typical Prinzmetal's angina and angiography proven coronary artery spasm are reviewed. In all cases the angina pain appeared at rest and was accompanied by a simultaneous ST-segment elevation. The coronary angiography results varied from severe multivessel disease (3 cases) to single vessel disease (3 cases), and normal coronary arteries (2 cases). In all patients a coronary spasm was documented, in five cases induced by ergonovine and in three spontaneously; in all patients but in one, the localization of the spasm was concordant with the ST-segment elevation localization. One case with a severe proximal left anterior descending stenosis was grafted; however the pain was not relieved despite treatment with large amounts of propranolol. This patient died after an episode of severe chest pain. Treatment with nifedipine was given to six patients, with excellent results in four cases, and regular response in two. The main physiopathologic diagnostic and therapeutic aspects of the variant angina syndrome are reviewed.

Aged↗
PubMed1979

Variant angina pectoris: investigation of indexes of sympathetic nervous system function.

One thousand forty-five spontaneous episodes of S-T segment elevation were observed in three patients over a total of 72 days of continuous electrocardiographic monitoring. Eighty-nine percent of episodes were asymptomatic; chest pain tended to occur with episodes longer than 3 minutes, and ventricular ectopy occurred almost exclusively with symptomatic episodes. Nitroglycerin regularly relieved angina or S-T elevation, or both. Plasma and urinary catecholamines and their metabolites were normal. Episodes of variant angina were not associated with a generalized increase in sympathetic outflow because serum catecholamine levels at the onset and termination of the S-T abnormalities were not elevated. Controlled trials of propranolol showed no significant beneficial effect. Propranolol significantly increased the length of episodes of S-T elevation in one patient, increasing ventricular irritability. The overall course of variant angina was quite variable, with spontaneous and long-lasting remissions, necessitating cautions interpretation of clinical trials.

Angina Pectoris↗
PubMed1985

Isosorbide dinitrate and nifedipine in variant angina pectoris.

The efficacy of isosorbide dinitrate (ISDN) in variant angina is enhanced by the addition of a calcium antagonist. A prospective double-blind, crossover trial of ISDN, 40 to 120 mg/day, and nifedipine, 40 to 120 mg/day, in 19 patients with variant angina and various degrees of coronary atherosclerosis showed that although both agents were equally effective in controlling angina of vasospastic origin, some patients responded better to one or the other drug. Such response could not be predicted by demographic factors, ECG changes, or degree of coronary atherosclerosis. Since quantitative angiography done in a similar group of patients showed that intracoronary nitroglycerin, 200 micrograms, was a more potent vasodilator than sublingual nifedipine, 10 mg (p less than 0.01), the calcium antagonists may have a different mechanism of preventing variant angina attacks and may act in an additive or synergistic fashion when administered in combination with long-acting nitrates. Such a combination will increase coronary blood flow, reduce ventricular volume and end-diastolic pressure, and reduce systemic arterial resistance. Coronary vasospasm may be directly prevented by a general inhibition of smooth muscle contraction by the calcium antagonist. Clinical studies suggest that combination therapy significantly improves the long-term prognosis of patients with variant angina and reduces the need for bypass surgery. Thus combining ISDN with a calcium antagonist is a rational and effective treatment for variant angina.

Angina Pectoris, Variant↗
PubMed1988

Effect of a new calcium antagonist, nilvadipine, on variant angina pectoris evaluated by 24-hour Holter electrocardiography.

The clinical effect of nilvadipine, a new calcium antagonist, was investigated in a single blind trial in 19 patients with variant angina pectoris. The efficacy of the drug was evaluated on the basis of frequency of anginal attacks and Holter electrocardiographic findings during observation periods and during two treatment periods when the drug was given in doses of 4 mg twice a day or 4 mg 3 times a day. The frequency of anginal attacks and the consumption of sublingual nitroglycerin tablets decreased significantly in both treatment periods in comparison with those in the observation period before treatment, but in the observation period after treatment tended to increase in comparison with those during the second treatment period. The frequency and duration of ST-segment elevation and the maximum ST-segment elevation confirmed by Holter electrocardiography also improved significantly in both treatment periods, compared with those in the observation period before treatment. Our findings show that nilvadipine is effective for variant angina pectoris at doses of 4 mg twice a day.

Angina Pectoris, Variant↗
PubMed1975

Variant angina pectoris: a clinical and coronary arteriographic spectrum.

The clinical course and coronary arteriographic findings in eight patients with Prinzmetal's variant angina pectoris are reviewed and contrasted to previously reported cases. In six patients with S-T-elevation inferiorly, three had normal coronary arteriograms, one had complete right coronary artery occlusion, one had diffuse triple-vessel disease, and one did not undergo coronary arteriography. In two patients with S-T-elevation anteriorly, severe stenosis of the anterior descending coronary artery was present. Medical treatment in four patients and surgical revascularization of the anterior descending coronary artery in two patients were both accompanied by marked symptomatic improvement. Spontaneous loss of angina occurred in two patients. During 17 months' mean follow-up, seven patients have remained free of angina and one died suddenly. Variant angina pectoris may be accompanied by a variety of coronary arteriographic findings and the prognosis appears more favorable than previously reported.

Adult↗