Rest and exercise angina caused by spasm of the left coronary artery. Apropos of a case with angiographically normal coronary arteries
Delaye, J.; Gayet, J.L.; Durand, J.P.; Fatayri, W.; Gaspard, P.; Jules, J.M.
Archives des Maladies du Coeur et des Vaisseaux 77(12): 1397-1402
1984
ISSN/ISBN: 0003-9683 PMID: 6439163 Document Number: 234999
A 42 year old woman presented with resting and effort angina. During an attack of chest pain, ST-T wave depression was recorded in the anterior chest leads. Coronary angiography showed spontaneous spasm of the left main stem, relieved by nitrate derivatives. The coronary arteries were angiographically normal between attacks of angina. Thallium 201 myocardial scintigraphy showed anterior wall hypofixation at maximal effort. A good therapeutic result was obtained with calcium antagonists. The site of coronary spasm is the special feature of this case, which may be grouped with other rare reported cases of spontaneous spasm or spasm on effort. We confirm that spasm-induced myocardial ischaemia may cause ST depression on the surface ECG.