Title: Coronary angiograms and the exercise electrocardiogram in the study of angina pectoris
Abstract: Fourteen patients in whom the diagnosis of coronary insufficiency had been confirmed by electrocardiograms obtained with the patients at rest or with exercise have been studied by coronary angiography. Eight of these who had the classic "effort angina" with depression of the S-T segment induced by two-step exercise or treadmill exercise were found to have single or multiple coronary occlusions conforming to the description of Blumgart, Schlesinger and Davis. One patient showed elongated narrow segments without occlusions. Another showed multiple local narrowed segments in the same vessel without occlusions. Three patients showed localized narrow segments strategically located so as to compromise the circulation to a large area of myocardium. These patients had predominantly nocturnal angina. Two had electrocardiographic changes during periods of pain, but not with standard exercise. These cases are believed to correspond to Prinzmetal's variant form of angina. In one case of adult coarctation, angina on effort was associated with depression in the S-T segment. The presence of adequate coronary arteries seen angiographically suggested that this form of coronary insufficiency is due to a discrepancy between the available myocardial blood supply and the greatly increased work of the heart during exercise. The findings indicate that myocardial ischemia may be brought about as a consequence of several different distributions of coronary atheroma. A rational surgical approach to the problem of coronary heart disease will depend on the recognition of these several types.
Publication Year: 1963
Publication Date: 1963-01-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
Access and Citation
Cited By Count: 27
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot