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Systemic alkalosis as a provocative test for coronary artery spasm in patients with infrequent resting chest pain
- Source :
- American heart journal. 115(1 Pt 1)
- Publication Year :
- 1988
-
Abstract
- Systemic alkalosis was used to detect coronary spasm in 237 patients with infrequent, resting, angina-compatible chest pain. The provocative test was performed without previous coronary arteriography but only in patients with negative submaximal exercise test results. Rapid infusion of alkaline solution followed by maximal hyperventilation raised arterial pH above the 7.65 value necessary for diagnostic significance in 196 (83%) patients. In 24 (12%) of these patients the provocative test induced significant ischemic ST segment changes. In all patients with a positive response, coronary artery disease, which was predominantly vasospastic (19 patients) or atheromatous with a vasospastic contribution (five patients), was demonstrated by coronary arteriography followed, if necessary, by ergot derivative injection. Chest pain and ECG changes were always reversed within 5 minutes by intravenous nitroglycerin. Coronary arteriography was not performed in all patients with a negative response; therefore, the sensitivity of the procedure could not be assessed. However, 36 patients with a negative response to hyperventilation underwent coronary arteriography; 33 (92%) had normal arteriograms and a negative response to ergot derivatives. Hyperventilation appears to be a safe and specific diagnostic procedure in a subset of patients in whom the probability of coronary artery disease may not be judged sufficient to warrant coronary arteriography as a primary diagnostic approach.
- Subjects :
- Adult
Male
medicine.medical_specialty
Chest Pain
Alkalosis
Provocative test
Coronary Vasospasm
Chest pain
Coronary artery disease
Internal medicine
Hyperventilation
medicine
ST segment
Humans
business.industry
Middle Aged
medicine.disease
medicine.anatomical_structure
Coronary vasospasm
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Artery
Subjects
Details
- ISSN :
- 00028703
- Volume :
- 115
- Issue :
- 1 Pt 1
- Database :
- OpenAIRE
- Journal :
- American heart journal
- Accession number :
- edsair.doi.dedup.....3b6c14926a121541e3f97a2344a919c9