Variable threshold of angina during exercise: A clinical manifestation of some patients with vasospastic angina

Stefano De Servi, Giuseppe Specchia, Maria Teresa Curti, Colomba Falcone, Antonello Gavazzi, Ezio Bramucci, Antonio Mussini, Luigi Angoli, Jorge Salerno, Piero Bobba

Research output: Contribution to journalArticle

Abstract

Two patients complained of chest pain while at rest and during physical activities. However there seemed to be no direct relation between exertional angina and an increasing level of work performed, indicating that these patients had a variable threshold of angina during exercise. In one patient spontaneous chest pain was associated with transient S-T segment changes in precordial leads, and during coronary arteriography the administration of ergonovine induced spasm of the left anterior descending coronary artery. The other patient showed S-T segment elevation in inferior leads during an ergonovine-induced anginal attack and coronary arteriography revealed a spontaneous spasm of the right coronary artery. In both patients repeated exercise tests yielded different results, because the chest pain and S-T segment depression occurred at different work loads with large differences in heart rate-systolic blood pressure product. It is concluded that a variable threshold of angina during exercise is a clinical manifestation in some patients with vasospastic angina and is probably due to the difference in coronary arterial tone at the onset of exercise.

Original languageEnglish
Pages (from-to)188-192
Number of pages5
JournalThe American Journal of Cardiology
Volume48
Issue number1
DOIs
Publication statusPublished - 1981

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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