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KMID : 0378120030300010037
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Chungnam Medical Journal
2003 Volume.30 No. 1 p.37 ~ p.48
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The Exercise Testings in Variant Angina
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Lee Jeong-Woo
Park Hyeong-Seo
Park Yong-Gyu
No Sang-Pil
Lee Yeu-Seon
Jeong Seung-Hyeon
Kim Bo-Yeong
Lee Jae-Hwan
Choi Si-Wan
Jung Jin-Ok
Sung In-Hwan
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Abstract
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No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina.
151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed.
Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed.
Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%).
Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.
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KEYWORD
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Variant angina, Treadmil exercise test
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