Variant Angina Pectoris
Autor: | Allen D. Johnson, Cdr W. V. R Vieweg, John Ross, Hilary A. Stroud |
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Rok vydání: | 1978 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Variant angina pectoris Bypass grafting Arterial disease business.industry Atherosclerotic disease Critical Care and Intensive Care Medicine medicine.disease Arterial spasm Pathophysiology Surgery Angina medicine.anatomical_structure Internal medicine medicine Cardiology Cardiology and Cardiovascular Medicine business Artery |
Zdroj: | Chest. 73:786-794 |
ISSN: | 0012-3692 |
DOI: | 10.1378/chest.73.6.786 |
Popis: | In 42 consecutive patients with variant angina pectoris, the initial clinical findings and the results of coronary angiographic studies were correlated with the therapeutic responses over an average follow-up period of 21 months (range, 3 to 51 months). Coronary angiographic anatomy varied from normal to significant three-vessel coronary arterial disease. Coronary spasm was documented in eight patients, both in the presence and absence of significant fixed coronary arterial obstructions. Twenty-seven patients had coronary arterial bypass grafting, including three patients with coronary spasm; results were generally satisfactory, particularly in patients with fixed obstructions confined to one major coronary artery. Medical therapy with nitrates has been successful in five of 11 patients without significant coronary obstructions. Of six patients with significant atherosclerotic lesions managed medically, two patients have sustained myocardial infarctions, and three are currently free from major symptoms. Only one of our 42 patients died. We conclude that variant angina has several pathophysiologic and anatomic substrates and that coronary arterial spasm plays a significant role, both in the presence and absence of atherosclerotic disease. Surgical therapy should be considered in all patients with significant atherosclerotic obstructions. Our limited experience with coronary arterial bypass grafting in patients without demonstrable atherosclerotic obstruction suggests that symptomatic improvement can result, and this approach can be considered when maximum medical therapy fails to relieve the symptoms or life-threatening ventricular arrhythmias. |
Databáze: | OpenAIRE |
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