Back to Search
Start Over
Role of coronary vasospasm in the pathogenesis of myocardial infarction: study in patients with no significant coronary stenosis.
- Source :
-
American heart journal [Am Heart J] 1993 Dec; Vol. 126 (6), pp. 1305-11. - Publication Year :
- 1993
-
Abstract
- The role of coronary vasospasm in the pathogenesis of myocardial infarction is unclarified. Among 212 patients with myocardial infarction in whom percutaneous transluminal coronary angioplasty (PTCA) or coronary thrombolysis was not performed at the acute stage, 21 patients (10%) showed no significant coronary stenosis (the degree of stenosis was less than 50% of the luminal diameter) by coronary angiography 4 weeks after myocardial infarction. Among them, 11 (52%) had preinfarction angina at rest, including two with variant angina, and nine (43%) had postinfarction angina at rest. Intracoronary ergonovine maleate induced coronary vasospasm in 12 (75%) of 16 patients examined. Coronary vasospasm occurred in the infarct-related coronary arteries in all patients, and importantly, multivessel coronary vasospasm occurred in 11 patients (69%). The infarct size was relatively small in these patients: (1) seven patients (33%) had Q wave myocardial infarction while 14 patients (67%) had non-Q wave myocardial infarction; (2) peak creatine phosphokinase (CPK) was lower than 1000 IU/ml in all patients; and (3) thallium-201 (Tl-201) scintigraphic study showed no perfusion defect in 8 of 18 patients. There was only one patient with congestive heart failure and no patient died. These results suggest that coronary vasospasm may play an important role in the pathogenesis of myocardial infarction in patients without significant coronary stenosis. The relatively small infarct size suggests that coronary reperfusion occurred in the early stages of myocardial infarction.
- Subjects :
- Adult
Aged
Case-Control Studies
Coronary Angiography
Coronary Disease complications
Coronary Vasospasm chemically induced
Electrocardiography
Ergonovine analogs & derivatives
Female
Humans
Male
Middle Aged
Myocardial Infarction pathology
Myocardial Infarction physiopathology
Myocardium pathology
Coronary Vasospasm complications
Myocardial Infarction etiology
Subjects
Details
- Language :
- English
- ISSN :
- 0002-8703
- Volume :
- 126
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- American heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 8249786
- Full Text :
- https://doi.org/10.1016/0002-8703(93)90527-g