PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Angina Pectoris, Variant”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMed1988

Alternans of the ST segment in variant angina. Incidence, time course and relation to ventricular arrhythmias during ambulatory electrocardiographic recording.

The ST alternans was recorded during at least one ischemic attack with ST elevation in nine of 65 patients with variant angina. The magnitude and duration of ST elevation during ischemic attacks were significantly greater in patients with than in those without ST alternans. It always appeared during the occlusion phase and disappeared during the reperfusion phase of ischemic attacks. In patients with episodic ST alternans, the ischemic attacks showed a greater ST elevation and a longer duration in the presence of ST alternans than in its absence. The incidence of occlusion phase ventricular arrhythmias was greater in patients with than in those without ST alternans; the incidence of reperfusion phase ventricular arrhythmias was similar in the two groups. The ST alternans always preceded the onset of occlusion phase arrhythmias. Thus, in variant angina, ST alternans represents an index of the severity of ischemia and a precursor of ventricular arrhythmias.

Angina Pectoris, Variant↗
PubMed1989

Increased peripheral vasoconstrictor reaction upon local cold in patients with coronary heart disease.

A local cold exposure test of the nailfold capillaries produces a typical flow stop reaction in 88% of patients with Raynaud's phenomenon. We applied this test to 12 patients with variant angina and compared the results with the findings in 2 control groups of 12 patients each, matched for age and sex: One group with chronic stable angina and one without heart disease. We found a flow stop with cold exposure in 9/12 patients with variant angina (mean duration 24 s), in 6/12 patients with chronic angina (mean 11 s), and in 1/12 normal controls without heart disease (mean 1 s). The frequency and duration of the flow stop was significantly higher in patients with variant angina (p = 0.002) and in patients with chronic stable angina (p = 0.02) than in normal controls. Patients with variant angina also tended to have an increased frequency and longer duration of the flow stop than those with chronic stable angina (p = 0.09). Administration of sorbidilate preparations and nifedipine resulted in a decrease of the mean flow stop duration from 23.5 to 10.8 s in patients with variant angina (p = 0.03). The strong association of a vasoconstrictive reaction in finger microcirculation and coronaries in patients with variant angina suggests a vasospastic tendency with manifestation in different vascular regions.

Adult↗
PubMed1986

Influence of a variant angina on the results of percutaneous transluminal coronary angioplasty.

Nineteen (86%) of 22 patients with variant angina and important coronary stenoses (greater than 60%) had successful percutaneous transluminal coronary angioplasty. The acute complications in two patients were not caused by coronary spasms but by dissection with disturbance of perfusion. One of these two patients required a coronary bypass graft; the other was treated conservatively. Myocardial infarction developed in both patients. Despite long term administration of nifedipine (30-80 mg daily), restenoses occurred within six months (on average after 10 weeks) in nine patients with symptoms and one without. In four patients the restenoses exceeded the degree of stenosis before angioplasty. Five patients were revascularised by surgical means. Vessels in three out of four patients were later successfully dilated. After a mean period of observation of 24 months (6-51 months) 18 of the 19 patients are symptom free and do not require medication. The results confirm that angioplasty is an effective method of treating patients with variant angina and important coronary stenoses. The problem of the high frequency of restenosis, however, remains unresolved.

Angina Pectoris, Variant↗
PubMed1998

Two cases of hypertrophic cardiomyopathy with coronary vasospasm.

Chest pain in patients with hypertrophic cardiomyopathy seems to be caused by relative myocardial ischemia due to the left ventricular outflow pressure gradient and myocardial hypertrophy. However, in 2 cases of hypertrophic cardiomyopathy chest pain was associated with coronary vasospasm. Thus, chest pain in these cases was decreased not by a beta-blocker but by isosorbide dinitrate and a calcium antagonist. Because beta-blockers are commonly used for hypertrophic obstructive cardiomyopathy and chest pain may be aggravated by beta-blockers in patients with coronary vasospasm, a combination of beta-blocker, isosorbide dinitrate and calcium antagonist was necessary for this hypertrophic cardiomyopathy with variant angina.

Adrenergic beta-Antagonists↗
PubMed2001

Comparative results of coronary intervention in patients with variant angina versus those with non-variant angina.

Coronary angioplasty is reported to be feasible and safe in patients with coronary spasm and fixed stenosis. However, the long-term results are not positive. We compared the results of coronary angioplasty in 20 patients with variant angina versus 17 patients with non-variant angina among 231 consecutive patients with vasospastic angina. Coronary angioplasty was performed successfully in all 37 patients without any complications. Stenting for coronary dissection or recoil was performed in 8 patients, directional coronary atherectomy was selected for ostial lesion of left anterior descending coronary artery stenosis in 2 patients, and standard balloon angioplasty was performed in 27 patients. There were no clinical differences between the two groups. The restensois rate in patients with variant angina was similar to that in patients with non-variant angina (30% vs 29%, ns). There was no relationship between the provoked spasm and restenosis. During the follow-up period, no major complications were observed in patients with variant angina or those with non-variant angina. In conclusion, full medication with calcium channel antagonists and isosorbide dinitrate, and treatment by coronary angioplasty including the use of new devices, were useful treatments for patients with coronary vasospasm and significant organic stenosis. There was no difference concerning the results of coronary intervention between the patients with variant angina and those with non-variant angina.

Aged↗
PubMed1992

Abnormal coronary vasomotion in ischemic heart disease.

Myocardial ischemia has long been thought to be caused by only critical arteriosclerotic plaques, which are the most obvious single denominators of ischemic cardiac syndromes. The author argues that just because other transient and dynamic mechanisms are more elusive than atherosclerotic plaques, we should not presume them to be unimportant. He reviews the work of his group and others, which suggests that dilation and constriction can occur at the site of coronary artery stenoses and in distal coronary vessels. Clinical and angiographic findings and the possible pathophysiological causes of vasomotor dysfunction that may modulate residual coronary flow in patients with chronic stable, unstable, and variant angina, and syndrome X are reviewed. Only when these mechanisms are more fully understood will it be possible to develop specific therapy.

Angina Pectoris, Variant↗
PubMed1985

[Arrhythmias in relation to transient ST elevations in Prinzmetal angina: induction by occlusion and reperfusion].

To study the temporal relationship of occlusion and reperfusion we examined 16 patients (14 m, 2f) with variant angina for the occurrence and time course of arrhythmias with episodes of ST-elevation (n = 82). The patients underwent frequency-modulated ambulatory ECG recording, episodes of ST elevation were defined, and the arrhythmias were counted before, during and after each episode. In 10 patients (group A) no or only infrequent extrasystoles occurred. Of the other 6 patients (group B), one had a-v block II degree, 5 had frequent (greater than 2/min) ventricular or supraventricular premature beats, 3 with couplets or runs of VPB. Patients of group A and B did not differ in age, severity of fixed coronary stenoses and ventricular ejection fraction. There was a tendency towards a greater incidence of higher ST-elevations (greater than 2 mm) in group B (4 of 6 patients versus 2 of 10 in group A, p = 0.09). The relationship of arrhythmias and ST changes showed different patterns: the maximum of arrhythmias occurred during the episode in 3 patients, during and after the episode in 2 patients and only after the episode in 1 patient. Potentially dangerous arrhythmias are frequent in patients with variant angina and persist beyond the ST segment changes in one half of the affected patients.

Aged↗
PubMedDate not supplied

The spectrum of coronary artery spasm. The variable variant.

Angina from coronary artery spasm is not rare. Because new and effective medical therapy is now available, it is imperative that the physician recognize this syndrome when it occurs. Coronary artery spasm can present clinically as unstable rest angina with reversible ST-segment elevation and bradyarrhythmias and tachyarrhythmias. In this setting, Prinzmetal's variant angina is generally promptly recognized and appropriately treated. The diagnosis is variant angina, however, often is not so obvious. Chest pain may be exertional or seem noncardiac in origin. The chest pain syndrome may be chronic and stable as well as unstable. The ECG may show ST-segment depression, rather than elevation. Five cases of coronary artery spasm that emphasize the variable features of variant angina and offer aid for the prompt diagnosis and treatment of the syndrome are presented here.

Angina Pectoris↗
PubMedDate not supplied

[Induction of coronary artery spasm by combined cold pressor and hyperventilation test in patients with variant angina].

To examine whether or not a combination of nonpharmacologic provocative tests potentiated the occurrence of coronary spasm, the cold pressor test combined with hyperventilation was studied in 22 consecutive patients with variant angina admitted to our hospital. After a 12-lead electrocardiogram and blood pressure were recorded, the patient was asked to hyperventilate vigorously at a rate of 30 respirations per min for 6 min under continuous electrocardiographic monitoring. Immediately after hyperventilation, the cold pressor test was performed with the patient's right hand submerged in ice water for 2 min. In some patients who showed a positive response to the combined test, a hyperventilation and cold pressor test was performed on another day. Positive response (ST segment elevation > or = 0.1 mV) to the combination test was seen in 18 of 22 patients (82%). Positive response to the hyperventilation test was seen in seven of 11 patients (64%). The response to cold pressor test was all negative in seven patients. The onset of electrocardiographic changes by the combined test occurred an average of 120 sec (30-240 sec) after the end of hyperventilation, whereas the onset by hyperventilation test occurred an average of 210 sec later (60-370 sec). These results suggest the combination of the cold pressor test and hyperventilation test potentiated the occurrence of coronary spasm. The combined cold pressor and hyperventilation test is a powerful and useful nonpharmacologic provocative test for coronary artery spasm in patients with variant angina.

Adult↗
PubMed1981

Complete denervation of the heart (autotransplantation) for treatment of severe, refractory coronary spasm.

A 49 year old man had severe refractory Prinzmetal's variant angina and angiographically documented coronary arterial spasm of a dominant circumflex artery. The spasm was provoked by methergine (an ergot alkaloid) and seemed resistant to various forms of medical therapy including administration of nitrates, nifedipine, verapamil, diltiazem and amiodarone. The attacks of angina at rest persisted at the rate of 7 to 15/day and were frequently associated with atrioventricular (A-V) block. After unsuccessful plexectomy performed in another institution, the patient underwent complete cardiac denervation (produced by autotransplantation). The follow-up data have interesting implications in relation to treatment of refractory variant angina, as well as possible mechanisms of coronary arterial spasm.

Angina Pectoris↗
PubMed1999

Alterations of autonomic nervous activity in recurrence of variant angina.

OBJECTIVE: To investigate whether autonomic nervous activity is involved in the recurrence of spontaneous coronary spasm in variant angina. DESIGN: Retrospective analysis. SETTING: Cardiology department of a university hospital. PATIENTS: 18 patients with variant angina were divided into single attack group (SA; nine patients) and multiple attack group (MA; nine patients) according to the frequency of ischaemic episodes with ST segment elevation during 24 hour Holter monitoring. METHODS: Heart rate variability indices were calculated using MemCalc method, which is a combination of the maximum entropy method for spectral analysis and the non-linear least squares method for fitting analysis, at 30 second intervals for 30 second periods, from 40 minutes before the attack to 30 minutes after the attack. High frequency (HF; 0.04-0.15 Hz) was defined as a marker of parasympathetic activity, and the ratio of low frequency (LF; 0.15-0.40 Hz) to high frequency (LF/HF) as an indicator of sympathetic activity. The averaged value during the 40 to 30 minute period before an attack was defined as the baseline. RESULTS: Compared with baseline, the HF component decreased in both groups at two minutes before the attack (p < 0.01), and the LF/HF ratio decreased at three minutes before the attack (p < 0.01). The baseline LF/HF was lower in the MA group than in the SA group (p < 0. 01). CONCLUSIONS: A reduction of sympathetic activity may play a key role in determining the recurrence of transient ischaemic events caused by spontaneous coronary spasm in patients with variant angina.

Aged↗
PubMed2000

A 25-year-old patient with low cardiac risk factors having a combination of variant angina and severe coronary arterial lesions--a case report.

A 25-year-old man with low cardiac risks underwent coronary arteriography because of chest pain at rest. His only risk factors for coronary artery disease was smoking. Both right and left coronary arteries were ectatic and the left anterior descending artery was obstructed. In the acetylcholine provocation test, the left circumflex coronary artery showed severe constriction. Thus, this patient was diagnosed as having a combination of variant angina and occlusive coronary artery disease.

Adult↗
PubMed1979

Variant angina. Clinical spectrum and results of medical and surgical therapy.

Fifty-four patients with variant angina are described. They are divided into patients without hemodynamically (less than 50%) important coronary artery lesions (Group 1), patients with intermediate (greater than or equal to 50% and less than 90%) fixed obstruction (Group 2A), and patients with high grade (greater than or equal to 90%) fixed obstruction (Group 2B). Inferior ischemia occurred significantly more often in Group 1 (90% versus 33%. p less than 0.001), and exertional angina was more frequent in Group 2 (70% versus 36%, p less than 0.05). Maximum medical therapy with propranolol and nitrates failed to control angina in 55% of Group 1, 69% of Group 2A, and 63% of Group 2B. Twelve patients underwent intra-aortic balloon pumping (IABP), and in 10 there was complete control of variant angina. A total of 35 Group I patients underwent coronary artery bypass grafting (CABG), with a 2.9% mortality rate in patients without preoperative cardiogenic shock. Of these patients, 55% in Group 2A and 73% in Group 2B experienced marked improvement in their angina status. Therefore, we currently recommend bypass grafting for medically intractable variant angina in those patients with severely stenotic, fixed atherosclerotic lesions.

Angina Pectoris↗
PubMed2004

Relationship between the degree of intracellular magnesium deficiency and the frequency of chest pain in women with variant angina.

OBJECTIVES: This study sought to clarify the relationship between the degree of intracellular magnesium deficiency and the frequency of anginal attacks in women with variant angina. PATIENTS AND METHODS: We evaluated the intracellular and extracellular magnesium status of twelve women with variant angina: group A (> or = 4 attacks/week, n = 5) and group B (< 4 attacks/week, n = 7). Magnesium levels were determined in serum, urine, and erythrocytes, and the 24-h magnesium retention rate was calculated by magnesium loading test. RESULTS: Group A showed a higher 24-h magnesium retention rate (58.2 +/- 9.1% vs. 31.3 +/- 4.4%; p < 0.01) and a lower intracellular concentration of magnesium in erythrocytes than group B (3.1 +/- 1.1 vs. 5.0 +/- 0.8 fg/cell; p < 0.05), demonstrating the presence of magnesium deficiency in group A. The 24-h magnesium retention rate and intracellular concentrations of magnesium in erythrocytes correlated well with the activity of variant angina (r = 0.61, p < 0.01; and r = -0.74, p < 0.01, respectively) for these patients. CONCLUSION: This study demonstrates that the degree of intracellular magnesium deficiency in women with variant angina is closely related to the frequency of chest pain.

Aged↗
PubMed1976

Clinical syndrome of variant angina with normal coronary arteriogram.

We compared patients with variant angina (ST-segment elevation during pain) who had normal or near normal coronary arteriograms (Group 1) with 20 in whom variant angina occurred in the presence of obstructive coronary lesions (Group 2). A long history of nonexertional angina without angina of effort or previous infarction was the rule in Group 1, whereas recent-onset unstable angina preceded by effort angina and infarction predominated in Group 2 (P less than 0.001). Normal electrocardiograms at rest, with ischemic ST-segment elevation in the inferior leads, and ischemia-induced heart block and bradycardia, characterized Group 1, whereas abnormal electrocardiograms, ischemic involvement or fibrillation were more common in Group 2 (P less than 0.001). Variant angina with normal coronary arteriogram generally has a benign course and is probably unrelated to atherosclerosis.

Adult↗
PubMed1980

Prinzmetal's variant angina during extradural anaesthesia.

A 55-yr-old male undergoing varicose vein surgery with an extradural block complained of chest pain. E.c.g. changes and subsequent examination of the heart including coronary angiography suggested the diagnosis of Prinzmetal's variant angina. The therapeutic implications of this condition in patients undergoing anaesthesia and surgery are discussed.

Anesthesia, Epidural↗