Abstract
The present study was designed to clarify the incidence of vasospastic angina in outpatients with anginal symptoms. From the patient history data taken on an outpatient basis, anginal symptoms were present in 464 (25.1%) among 1850 consecutive individuals above 40 years of age. Of these patients with anginal symptoms, further diagnostic studies including coronary angiography were performed in 322. Best efforts were made to obtain recordings of the 12 lead electrocardiogram during chest pain. The ergonovine provocation test was performed during cardiac catheterization in 197 of 221 (89.1%) patients without a critical degree of stenosis in coronary arteries (≥75%, AHA) and also in 8 of 60 patients with critical coronary stenosis. Patients that had had a prior myocardial infarction were not included in this test. Developement of ergonovine-induced focal coronary constriction of more than 90% associated with ischemic change in the ST segment (more than 0.1mV) on the EGG was defined as a positive response for coronary spasm. As a consequence, prior myocardial infarction was found in 41 patients and angina pectoris in 106, including 55 patients with vasospastic angina in which documented ST elevation during chest pain or a positive ergonovine test was noted. The overall incidence of vasospastic angina was 17.1% (55/322).
