There are a large number of deaths from coronary disease in which a necropsy examination generally gives less evidence of the exact cause of death than the clinical findings. In the absence of fatal structural lesions, acute coronary deaths have been attributed to disturbances of function such as inhibition, arrhythmias, and coronary spasm; but the problem has been one ofdebate rather than obse...

The authors present a clinical case of coronary artery spasm in a 62-year-old woman undergoing elective aortic valve replacement surgery for aortic regurgitation. On admission at ICU, the patient developed marked hemodynamic and electrical instability. Emergent coronary angiography demonstrated a pronounced spasm of the distal portion of the right coronary artery, apparently related to compress...

BACKGROUND Regional left ventricular (LV) diastolic wall motion abnormalities detected by color kinesis (CK), an echocardiographic technique, may be a more sensitive measure to postischemic damage following coronary spasm than parameters of global diastolic function. METHODS AND RESULTS Regional LV diastolic wall motion was evaluated by using CK in 18 patients with variant angina on the day f...

OBJECTIVES The role of endothelin-1 (ET-1) in the pathogenesis of coronary artery spasm is not well understood. We aimed to determine if ET-1 is involved in serotonin-induced coronary spasm in the swine model. METHODS In 10 miniature pigs, a segment of the left anterior descending coronary artery was denuded and irradiated with X-ray. Three months after endothelial denudation, coronary vasomo...

Sir, I read with interest the article on Prinzmetal's angina and coronary artery spasm by Huckell and coworkers (Br Heart J 1981; 45: 649-55). The authors mentioned the association of mitral valve prolapse in eight of their 18 patients with Prinzmetal's angina, and wondered whether this finding was causative or coincidental, or whether patients with mitral prolapse were more prone to develop co...

a case of angina pectoris and in the experimental animal. Angiology. 1962;13:550-553. Guazzi M, Polese A, Fiorentini C, Magrini F, Bartorelli C. Left ventricular performance and related haemodynamic changes in Prinzmetal's variant angina pectoris. Br Heart J. 1971;33:84-94. Dhurandhar RW, Watt D, Silver M, Trimble A, Adelman A. Prinzmetal's variant form of angina with arteriographic evidence of...

Papillary muscle rupture usually occurs as a catastrophic complication of acute myocardial infarction in patients with coronary artery stenosis; it is therefore less common in patients without coronary artery stenosis. We report the case of a 67-year old woman without coronary artery stenosis who suffered an acute anterolateral papillary muscle rupture and was successfully treated with mitral v...

A 60-year-old man was prescribed oral desmopressin (1-deamino-8-D-arginine vasopressin acetate trihydrate; DDAVP) for nocturnal polyuria. One week after starting to take desmopressin, he frequently felt chest pain while resting. Coronary angiography revealed no organic stenosis; however, an acetylcholine provocation test showed severe coronary spasm with ST elevation. He was diagnosed with coro...

Coronary artery spasm has been recognised recently as a possible cause of perioperative myocardial ischaemia after coronary artery bypass grafting. We report on one case and review the published reports. We emphasise the clinical picture of the patient who is liable to have spasm and the necessity for a prompt diagnosis and correct treatment.

Four patients with variant angina pectoris exhibited reproducible exercise-induced chest pain and ST-segment elevation. Coronary arterial spasm was documented with arteriography during exercise-induced ST-segment elevation (three patients) or after intravenous administration of ergonovine maleate (one patient). Our observations show that in patients with variant angina exercise can trigger coro...