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Titolo:
Clandestine ischemia in patients with vasospastic angina
Autore:
Coma-Canella, I; Martinez-Caro, D; Cosin-Sales, J; Fernandez-Jarne, E; Velloso, MJG; Gimenez, M;
Indirizzi:
Univ Navarra, Fac Med, Clin Univ, Dept Cardiol, E-31080 Pamplona, Spain Univ Navarra Pamplona Spain E-31080 ept Cardiol, E-31080 Pamplona, Spain Univ Navarra, Fac Med, Clin Univ, Dept Nucl Med, E-31080 Pamplona, Spain Univ Navarra Pamplona Spain E-31080 pt Nucl Med, E-31080 Pamplona, Spain
Titolo Testata:
CORONARY ARTERY DISEASE
fascicolo: 5, volume: 11, anno: 2000,
pagine: 383 - 390
SICI:
0954-6928(200007)11:5<383:CIIPWV>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY SPASM; SILENT-MYOCARDIAL-ISCHEMIA; EMISSION COMPUTED-TOMOGRAPHY; VARIANT ANGINA; SUDDEN-DEATH; EXERCISE; SCINTIGRAPHY; PECTORIS; ATTACKS; FLOW;
Keywords:
vasospastic angina; variant angina; exercise-stress test; thallium scintigraphy; clandestine ischemia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Coma-Canella, I Univ Navarra Clin, Dept Cardiol, Apto 4209, Pamplona, Spain Univ Navarra Clin Apto 4209 Pamplona Spain mplona, Spain
Citazione:
I. Coma-Canella et al., "Clandestine ischemia in patients with vasospastic angina", CORON ART D, 11(5), 2000, pp. 383-390

Abstract

Background Coronary vasospasms generally occur at rest, but can also be triggered by physical exercise. Anginal pain and ST-segment elevation may be seen during exercise-stress tests. ST-segment depression, due to nonocclusive vasospasms, has also been found to occur. When the result of a test is positive, scintigraphy usually reveals perfusion defects. True silent or clandestine ischemia (normal result of exercise test with perfusion defects) in these patients is very uncommon. Objective To stress the need for suspecting occurrence of coronary vasospasms in order to perform a proper diagnosis. Methods Eight patients with angina were selected for this study. They had negative results of exercise tests with perfusion defects detected by thallium-201 tomography, normal coronary arteries and vasospasms. Maximal exercise-stress tests with thallium-201 tomography were performed, Sizes of perfusion defects were quantified by examining polar maps. Coronary angiography and then an intracoronary ergonovine test were performed for each patient. Results Significant defects were seen in territory of the right coronary artery, the left anterior descending artery, or both. Lung:heart ratio was normal in every case. The coronary arteries were normal and vasospasms were elicited with ergonovine in all the patients. Correspondence between the location of perfusion defects and angiographic spasms was generally observed. After treatment with calcium antagonists and nitrates all of them improvedand defects detected by thallium tomography were no longer found when tests were repeated. Conclusions Some patients with vasospastic angina may have normal results of exercise-stress tests and reversible perfusion defects detectable by scintigraphy. This finding must lead one to perform coronary angiography without administration of nitroglycerine beforehand and an ergonovine test if the coronary arteries are normal. Coron Artery Dis 11:383-390 (C) 2000 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 21:28:22