Circulation, Vol 61, 1159-1164, Copyright © 1980 by American Heart Association
DD Waters, P Theroux, J Crittin, F Dauwe and HF Mizgala
Variant angina was diagnosed after coronary artery bypass surgery in six
patients over a 22-month period. Although all six patients had at least
occasional angina at rest preoperatively, all but one had predominantly
exertional angina. After surgery, rest angina with transient ST-segment
elevation appeared in all six after an asymptomatic interval of 1 week to 4
years. In two patients the involved artery had not been bypassed, in two
patients it was perfused by a patent graft and in two patients the graft to
the involved vessel was occluded. Treatment with calcium antagonist drugs
(four cases) or isosorbide dinitrate (one case) eliminated symptoms; one
patient spontaneously became asymptomatic. The diagnosis of variant angina
should be considered when rest angina occurs after bypass surgery,
particularly if exertional angina is absent and grafts are patent.
ARTICLES
Previously undiagnosed variant angina as a cause of chest pain after coronary artery bypass surgery
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