Transient myocardial ischemia with minimal electrocardiographic changes: an echocardiographic study in patients with Prinzmetal's angina |
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| Authors: | D Rovai A Distante E Moscarelli M A Morales E Picano C Palombo A L'Abbate |
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| Affiliation: | 1. Internal Medicine Department, Yerevan State Medical University after M. Heratsi, Yerevan, Republic of Armenia;2. Cardiology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Republic of Armenia;3. Internal Medicine Department, D. Halytsky Lviv National Medical University, Lviv, Ukraine;4. School of Medicine, Iran University of Medical Sciences, Teheran, Islamic Republic of Iran;5. Isfahan Cardiovascular-Research Center, Isfahan University of Medical Science, Isfahan, Islamic Republic of Iran;6. Clinical Pharmacology and Cardio-Oncology Department and Cardio-Oncology Center, M.D. Strazhesko Institute of Cardiology, Kiev, Ukraine;7. Sapienza University of Rome, Rome, Italy;8. School of Medicine, Insubria University Varese, Lombardy, Italy;9. Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine;10. Internal Disease Propedeutics Department, Yerevan State Medical University after M. Heratsi, Yerevan, Republic of Armenia;1. Saglik Bilimleri University, Bursa Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic Bursa, Turkey;2. Saglik Bilimleri University, Bursa Yuksek Ihtisas Training and Research Hospital, Ophthalmology Clinic Bursa, Turkey;3. Saglik Bilimleri University, Bursa Yuksek Ihtisas Training and Research Hospital, Neurology Clinic Bursa, Turkey |
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| Abstract: | Kn patients with Prinzmetal's angina, episodes of transient T wave abnormalities (T abn) are often documented in addition to the typical episodes of ST segment elevation (ST). As the interpretation of these minor ECG changes is still uncertain, we investigated if transient T abn are associated with reversible ventricular asynergies, similar to episodes with ST. For this purpose an ECG lead and a two-dimensional echocardiographic projection, which showed clear-cut changes during previous episodes of ST, were simultaneously monitored in five patients with Prinzmetal's angina for a total of 13 hours and 20 minutes. In all patients, the 30 episodes of ST recorded were all accompanied by reversible ventricular asynergies. Furthermore, in four of these patients, 14 episodes of T abn (peaking, flattening, or the appearance of a diphasic T wave) were recorded. All T abn were associated with reversible asynergies, as detected by three independent observers. The mechanical impairment occurred in the same ventricular wall both during ST and during T abn. During T abn the degree of mechanical impairment appeared less severe (hypokinesia in 12 and akinesia in two episodes) than during ST (hypokinesia in one, akinesia in 25, and dyskinesia in four episodes) (p less than 0.001). The duration of asynergies was less during T abn (107 +/- 76 seconds) than during ST (169 +/- 83 seconds) (p less than 0.05). Chest pain was reported in 5 of 14 episodes of T abn (36%) and in 20 of 30 (66%) episodes of ST (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) |
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