Coronary arterial spasm as a cause of exercise-induced ST-segment elevation in patients with variant angina.

Specchia, Giuśeppe; Servi, Stefano De; Falcone, Colomba; Bramucci, Ezio; L, Angoli; Antonio, Martín; Marinoni, G. P.; Montemartini, C; Bobba, P

doi:10.1161/01.cir.59.5.948

Cited by 187 publications

(40 citation statements)

References 20 publications

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“…The atria and great vessels were separated from the ventricles, which were then weighed, placed in 10% buffered formalin for 3 …”

Section: Methodsmentioning

confidence: 99%

Proximal coronary vasomotor reactivity after exercise training in dogs.

Bové¹,

Dewey²

1985

Circulation

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The effects of exercise on large coronary vasoreactivity were determined in eight dogs trained by treadmill running for 8 weeks. Six nontrained dogs comprised the control group. The trained group showed a significant reduction in heart rate during graded submaximal exercise testing when compared with the controls, and resting plasma levels of norepinephrine (nontrained group, 331 + 99 pg/ml; trained group, 142 30 pg/ml; p < .05) and epinephrine (nontrained, 424 -+-

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“…The atria and great vessels were separated from the ventricles, which were then weighed, placed in 10% buffered formalin for 3 …”

Section: Methodsmentioning

confidence: 99%

Proximal coronary vasomotor reactivity after exercise training in dogs.

Bové¹,

Dewey²

1985

Circulation

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“…3,10,19), and spontaneous ST elevation was recorded in 7 patients (No. 8,9,11,12,13,21,23). In total, the ECG indicated ischemic changes in 17 patients (59%) using noninvasive procedures.…”

Section: Correlation Between the Locality Of Transient Perfusion Defementioning

confidence: 99%

Usefulness of Hyperventilation Thallium-201 Single Photon Emission Computed Tomography for the Diagnosis of Vasospastic Angina.

et al. 1995

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SUMMARYTo establish a safe and sensitive diagnostic procedure for detecting coronary vasospasm, we utilized 201-thallium myocardial SPECT combined with hyperventilation (HV-SPECT) in 29 patients with vasospastic angina (VAP) and 11 controls.Twenty-five of 29 patients with VAP and 5 of 11 controls developed transient perfusion defects on HV-SPECT, resulting in a sensitivity and specificity calculated at 86% and 55%, respectively.Overall accuracy in identifying corresponding vessels with coronary vasospasm was 67%; it was 83%, 75% and 42% for patients with 1, 2 and 3 vessel spasm, respectively. Coronary vasospasm tended to be identified more accurately in the left anterior descending branch and the right coronary artery than in the circumflex branch (75%, 71% and 50%, respectively).The hyperventilation test induced ischemic ECG changes in 11 of 29 patients with VAP, yielding a sensitivity of 38%. Analyzing the washout rate of HV-SPECT in patients with VAP, both the extent and severity scores of patients with ischemic ECG changes were larger than those of patients without. No serious complications occurred during HV-SPECT.In conclusion, HV-SPECT was a safe and sensitive procedure as a primary diagnostic approach for VAR From the results of washout analysis, HV-SPECT could detect more mild myocardial ischemia than could the ECG, and seemed quite useful especially for detecting coronary vasospasm accompanied by minimal ischemic ECG changes. (Jpn Heart J 36: 405-420, 1995)

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“…Elevação da PAD até 120mmHg nos normotensos; elevação da PAD até 140mmHg nos hipertensos; queda sustentada da PAS; elevação acentuada da PAS até 260mmHg; manifestação clínica de desconforto torácico, exacerbada com o aumento da carga ou que associada a alterações eletrocardiográficas de isquemia, ataxia, tontura, palidez e pré-síncope; dispnéia desproporcional à intensidade do esforço; infradesnível do segmento ST de 0,3mV ou 3mm, adicional aos valores de repouso na presença de DAC suspeita ou conhecida; supradesnível do segmento ST de 0,2mV ou 2mm 48,49 , em derivação que observe região sem presença de onda Q; arritmia ventricular complexa; aparecimento de TSV sustentada, taquicardia atrial, FA, BAV de 2º ou 3º graus; IVE, com atenção especial no indivíduo idoso, uma vez que o achado de estertores crepitantes à ausculta pulmonar não é infreqüente, mesmo na ausência de sintomas; falência dos sistemas de monitorização e/ou registro.…”

Section: Iii3 -Critérios De Interrupção Do Esforçounclassified

“…Supradesnivelamento do ST -Achado infreqüente durante a realização do TE 48,49 , tem sua prevalência na dependência da população estudada. É de ocorrência comum em pacientes com IAM com Q e, à semelhança da depressão do segmento ST. É quantificado como resposta anormal o desvio positivo de 1mm (medido ao nível da junção J/ST) em relação à linha de base imaginária que une a junção PQ de pelo menos 2 complexos QRS sucessivos.…”

Section: Iv2 -Respostas Eletrocardiográficasunclassified