Arteriographic Demonstration of Coronary Artery Spasm and Its Release After the Use of a Vasodilator in a Case of Angina Pectoris and in the Experimental Animal

Gensini, Goffredo G.; Giorgi, Salvatore Di; Murad-Netto, Stans; Black, Asher; Kelly, Ann E.

doi:10.1177/000331976201301202

Cited by 93 publications

(15 citation statements)

References 2 publications

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“…5 Coronary artery spasm is an important, if not the most important, feature of variant angina.6-10 It is possible that coronary arterial spasm could play a significant role throughout the wide spectrum of ischemic heart disease.1'"14 The incidence of spasm in the patient undergoing coronary arteriography is not, however, well documented. In this study we aimed to establish the incidence of spasm provoked pharmacologically in 1089 patients who underwent angiography.…”

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confidence: 99%

Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography.

Bertrand¹,

Lablanche²,

Tilmant³

et al. 1982

Circulation

464

184

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SUMMARY We established the incidence of coronary artery spasm provoked by 0.4 mg of methergine in 1089 consecutive patients undergoing coronary angiography. The test was performed after routine coronary arteriography. Subjects included patients with angina, both typical and atypical, patients who had recently had myocardial infarction and patients with either valvular disease or congestive cardiomyopathy. Patients with spontaneous spasm, left main narrowing or severe three-vessel disease were excluded. One hundred thirty-four patients experienced focal spasm. Focal spasm was uncommon in patients with atypical precordial pain (1.2%), angina of effort (4.3%), valvular disease (1.95%) or cardiomyopathy (0%). It occurred most often in patients with angina at rest and less often in patients with angina both at rest and induced by exercise. Spasm was provoked in 20% of patients with recent transmural infarction, but in only 6.2% of patients studied later after infarction. Spasm was superimposed on fixed atherosclerotic lesions in 60% of the patients. No serious complications were encountered.Although the patients who underwent provocation tests in this study are not representative of all patients with coronary artery disease, spasm occurred in 20% of patients who experienced a coronary event and in 15% of patients who complained of chest pain.

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mentioning

confidence: 99%

Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography.

Bertrand¹,

Lablanche²,

Tilmant³

et al. 1982

Circulation

464

184

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“…The first reported case of coronary artery spasm relieved by an organic nitrate was documented by Gensini et a1 in 1962 [6]. In their patient, diffuse spasm was visualized in both the right and left coronary arteries following aortic root injection of contrast material during diastolic arrest with 0.4 mg acetylcholine.…”

Section: Discussionmentioning

confidence: 94%

Relief of coronary artery spasm by nitroglycerin: Time‐dependent variability in drug action

Fallen

Cairns

Stolberg

et al. 1978

Cathet. Cardiovasc. Diagn.

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The arteriographic distinction between a fixed atheromatous obstruction and localized vasospasm in the coronary artery is often decided by the response of the lesion to nitroglycerin. We studied the time course of nitroglycerin in four patients with coronary artery spasm as revealed by selective angiography. Following complete dissolution of a 0.6 mg tablet of nitroglycerin sublingually a slight increase in heart rate occurred as early as two minutes, variable changes in overall vessel diameter were observed within four minutes, but the localized spasm remained fixed. It was not until six minutes had elasped that reinjection showed disappearance of spasm and uniform patency of the vessel in all cases. These observations stress the importance of waiting an appropriate period of time (at least six minutes) following complete absorption of sublingual nitroglycerin before any conclusion can be rationally drawn regarding the nature of a stenotic lesion as seen angiographically.

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“…Spasm of large epicardial coronary arteries causes angina at rest associated with ST elevation (Gensini et al 1962) or depression (Maseri et al 1977;Yasue et al 1981). In addition to rest angina, coronary artery spasm plays a pivotal role in a broad spectrum of coronary ischemic syndromes, including exercise-induced angina, silent myocardial ischemia, pre-infarction (unstable) angina, acute myocardial infarction, postinfarction angina, syncope, and sudden cardiac death ( Fig.…”

Section: Coronary Artery Spasm and Coronary Ischemic Syndromesmentioning

confidence: 99%

Coronary Artery Spasm: Part I Clinical Aspect

Shimokawa

2014

PanVascular Medicine

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Arteriographic Demonstration of Coronary Artery Spasm and Its Release After the Use of a Vasodilator in a Case of Angina Pectoris and in the Experimental Animal

Cited by 93 publications

References 2 publications

Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography.

Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography.

Relief of coronary artery spasm by nitroglycerin: Time‐dependent variability in drug action

Coronary Artery Spasm: Part I Clinical Aspect

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