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European Heart Journal 1983 4(8):532-535;
Copyright © 1983 by the European Society of Cardiology.
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© 1983, by the European Society of Cardiology

The provocation of coronary arterial spasm in patients with recent transmural myocardial infarction

M. E. BERTRAND*,, J. M. LABLANCHE*, P. Y. TILMANT*, F. A. THIEULEUX*, M. G. DELFORGE* and R. A. CHAHINE{dagger}

*Division of Cardiology and Haemodynamics, University Hospital Lille, France
{dagger}Baylor College of Medicine Houston, Texas, U.S.A.

Received 3 June 1982; revised 15 November 1982; .

Address for reprints: M. E. Bertrand. Division of Cardiology and Haemodynamics, HÔpital Cardiologique. 59 037 Lille cedex, France.

Abstract

Provocative tests for coronary spasm were performed in a group of 131 patients (124 men and 7 women) with recent (<6 weeks) transmural myocardial infarction. Coronary arteriography was performed 27±9 days after the onset of the infarction. The provocative test was performed using a single IV bolus of 0.4 mg of ergometrine. Aortic pressure, ECG and arteriograms of the two coronary vessels were repeated 3 and 5 min later. Provoked spasm was observed in 27 (21%) of the patients. In 13 (48%) the coronary spasm occurred in a vessel presumed to be responsible for the myocardial infarction, while it was observed in coronary artery unrelated to the area of the infarct in 14 (52% of the cases with spasm). Thus, this study demonstrates a high degree of reactivity of the coronary tree of patients with recent transmural myocardial infarction suggesting the likelihood of a role for spasm in the infarction process and offering some explanation for subsequent recurrent ischemic events.

Key Words: Myocardial infarction • coronary spasm


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