Circulation, Vol 65, 1299-1306, Copyright © 1982 by American Heart Association
ME Bertrand, JM LaBlanche, PY Tilmant, FA Thieuleux, MR Delforge, AG Carre, P Asseman, B Berzin, C Libersa and JM Laurent
We established the incidence of coronary artery spasm provoked by 0.4 mg of
methergine in 1089 consecutive patients undergoing coronary angiography.
The test was performed after routine coronary arteriography. Subjects
included patients with angina, both typical and atypical, patients who had
recently had myocardial infarction and patients with either valvular
disease or congestive cardiomyopathy. Patients with spontaneous spasm, left
main narrowing or severe three- vessel disease were excluded. One hundred
thirty-four patients experienced focal spasm. Focal spasm was uncommon in
patients with atypical precordial pain (1.2%), angina of effort (4.3%),
valvular disease (1.95%) or cardiomyopathy (0%). It occurred most often in
patients with angina at rest and less often in patients with angina both at
rest and induced by exercise. Spasm was provoked in 20% of patients with
recent transmural infarction, but in only 6.2% of patients studied later
after infarction. Spasm was superimposed on fixed atherosclerotic lesions
in 60% of the patients. No serious complications were encountered. Although
the patients who underwent provocation tests in this study are not
representative of all patients with coronary artery disease, spasm occurred
in 20% of patients who experienced a coronary event and in 15% of patients
who complained of chest pain.
ARTICLES
Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography
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