抄録
Combination of coronary artery spasm and organic coronary stenosis has been postulated as a possible cause of spontaneous angina. The present study was performed to clarify the role of organic stenosis and spasm of coronary artery in spontaneous angina according to the coronary arteriography and the shifts of ST-segment in the 12-lead ECG during anginal attack in 53 patients with spontaneous angina. In 33 cases of ST elevation during attack, only 14 cases (42 %) had organic stenosis. Three cases had multivessel disease (MVD), and 3 cases had collateral vessels. The incidence of organic stenosis in the corresponding artery to the electrocardiogram was higher in the anteroseptal area than in the inferior area. In 20 cases of ST depression during attack, 19 cases (95 %) had organic stenosis. Fourteen cases had MVD and 10 cases had collateral vessels. The incidence of organic stenosis, including MVD, and collateral vessels was higher in cases of ST depression than in cases of ST elevation. And also the incidence of positive response to the exercise test is higher in cases of ST depression than in cases of ST elevation. The results suggest that coronary spasm is the main cause of spontaneous angina in cases of ST elevation, and organic stenosis of coronary artery in addition to coronary spasm is the main cause of the anginal attack in cases of ST depression.
