PMID: 9431481Aug 1, 1997Paper

Correlation between arteriographic and electrocardiographic features during spasm in the left anterior descending coronary artery

Coronary Artery Disease
T MatsubaraY Aizawa

Abstract

The clinical role of collateral vessels, which are transiently augmented during coronary artery spasm, remains controversial. To examine the correlation between coronary arteriographic and electrocardiographic features during spasm in the left anterior descending artery (LAD). We studied 45 patients in whom LAD spasms were induced by administration of acetylcholine or ergonovine maleate into the left coronary artery, or in whom spontaneous LAD spasms were documented during diagnostic cardiac catheterization. During spasm, only three patients had transient appearance or augmentation of collateral flow opacifying the LAD. In these three patients, electrocardiograms obtained from anterior precordial chest leads during LAD spasm showed ST-segment depression, ST-segment elevation followed by ST-segment depression, and only T-wave change, respectively. Except for these three patients, ST-segment elevations were observed in all other patients (31 of 34) with main-branch spasm of the LAD. However, ST-segment elevation was observed in only two of 11 patients in whom spasm of the diagonal branch alone was induced. Our observations suggest that the electrocardiographic changes during spasm are not always a sensitive indicator of LAD side ...Continue Reading

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