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Long-term observations in patients with angina and normal coronary arteriograms.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Pepine, Carl J. |
| Copyright Year | 1973 |
| Abstract | SUMMARY Thirty-seven patients (mean age 42.7 years) with angina pectoris (AP), ischemic myocardial abnormalities, and normal coronary arteriograms were followed for 4.1 years (mean). Twenty patients had typical and 17 atypical AP. Ten had abnormal serum lipids, and eight had abnormal glucose tolerance tests. Rest-to-exercise hemodynamics revealed increased left ventricular (LV) end-diastolic pressure (mean 11.2 2.6 mm Hg 19.1 3.6, P < 0.05), while stroke-work index increased (+29%). LV ischemia was detected by abnormal lactate extraction with atrial pacing in 10 or >1 mm S-T segment depression during exercise or pacing in 27 patients. After a mean follow-up period of 4.1 years, AP decreased in 80% of cases and remained stable in the other 20% of cases. One patient died suddenly, and autopsy revealed normal coronary arteries and myocardium. In the remainder, complications of ischemia, i.e. progression of symptoms , infarction, and heart failure were absent. Seven patients restudied 4.5 years (mean) later had no changes in their previously documented hemodynamic abnormalities and normal coronary arteriograms. The fate of patients with AP and normal coronaries with ischemic LV abnormalities (ECG, metabolic, or hemodynamic) appears favorable. AP responds to nitrate and propranolol therapy. These long-term clinical observations with angiographic and hemodynamic restudies suggest a nonprogressive disorder. Additional Indexing Words: Coronary angiography Angina pectoris Propranolol Atypical angina pectoris Myocardial ischemia I SCHEMIC electrocardiographic, hemodynamic, and myocardial metabolic abnormalities accompany significant coronary obstruction in the large majority of angina pectoris patients studied.14 Considerable interest, however, has attended recent reports indicating that angina pectoris associated with evidence of myocardial ischemia may be encountered in patients having angiographically normal coronary arteries without other types of cardiovascular disease.5 1 Since angina pectoris in the presence of significant coronary artery disease has been associated with a heightened incidence of morbidity and sudden death, the recognition of this symptom in the absence of obstructive coronary artery disease has raised numerous questions. 36 Central among these relates to the clinical significance of angina pectoris in this setting as a harbinger of serious morbidity. The purpose of this study is to report our long-term observations in such a group of patients with the anginal syndrome and normal coronary angiography. Materials and Methods The study group comprised 37 patients (21 males, 16 females) who underwent diagnostic studies to evaluate an anginal syndrome. All had normal selective coronary angiography reviewed independently by two of us, and objective evidence (electrocardiographic and/or myocardial metabolic … |
| Starting Page | 36 |
| Ending Page | 43 |
| Page Count | 8 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/47/1/36.full.pdf |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/47/1/36.full.pdf?download=true |
| PubMed reference number | 4686602v1 |
| Volume Number | 47 |
| Issue Number | 1 |
| Journal | Circulation |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Angina Pectoris Arteriopathic disease Cerebrovascular accident Cessation of life Congenital Abnormality Coronary Artery Disease Coronary angiography Depressive disorder Diagnostic tests Diastole Diastolic blood pressure Dietary Mercury Document completion status - Documented Eighty Glucose Metabolism Disorders Glucose tolerance test Heart Atrium Heart failure Hemodynamics Indexes Infarction Lactic acid Metabolic Process, Cellular Mood Disorders Morbidity - disease rate Myocardial Ischemia Myocardium Nitrates Obstruction Patients Propranolol Sudden death Tooth Abnormalities Ventricular Dysfunction, Left angiogram arteriogram |
| Content Type | Text |
| Resource Type | Article |
