BACKGROUND: We will focus our attention in this article in the ECG changes of classical Prinzmetal angina that occur during occlusive proximal coronary spasm usually in patients with normal or noncritical coronary stenosis. RESULTS: The most important ECG change during a focal proximal coronary spasm is in around 50% of cases the appearance of peaked and symmetrical T wave that is followed, if the spasm persist, by progressive ST-segment elevation that last for a few minutes, and later progressively resolve. The most frequent ECG changes associated with ST-segment elevation are: (a) increased height of the R wave, (b) coincident S-wave diminution, (c) upsloping TQ in many cases, and (d) alternans of the elevated ST-segment and negative T wave deepness in 20% of cases. The presence of arrhythmias is very frequent during Prinzmetal angina crises, especially ventricular arrhythmias. The prevalence and importance of ventricular arrhythmias were related to: (a) duration of episodes, (b) degree of ST-segment elevation, (c) presence of ST-T wave alternans, and (d) the presence of >25% increase of the R wave. CONCLUSIONS: The incidence of Prinzmetal angina is much lower then 50 years ago for many reasons including treatment with calcium channel blocks to treat hypertension and ischemia heart disease and the decrease of smoking habits.
BACKGROUND: We will focus our attention in this article in the ECG changes of classical Prinzmetal angina that occur during occlusive proximal coronary spasm usually in patients with normal or noncritical coronary stenosis. RESULTS: The most important ECG change during a focal proximal coronary spasm is in around 50% of cases the appearance of peaked and symmetrical T wave that is followed, if the spasm persist, by progressive ST-segment elevation that last for a few minutes, and later progressively resolve. The most frequent ECG changes associated with ST-segment elevation are: (a) increased height of the R wave, (b) coincident S-wave diminution, (c) upsloping TQ in many cases, and (d) alternans of the elevated ST-segment and negative T wave deepness in 20% of cases. The presence of arrhythmias is very frequent during Prinzmetal angina crises, especially ventricular arrhythmias. The prevalence and importance of ventricular arrhythmias were related to: (a) duration of episodes, (b) degree of ST-segment elevation, (c) presence of ST-T wave alternans, and (d) the presence of >25% increase of the R wave. CONCLUSIONS: The incidence of Prinzmetal angina is much lower then 50 years ago for many reasons including treatment with calcium channel blocks to treat hypertension and ischemia heart disease and the decrease of smoking habits.
Authors: R J Myerburg; K M Kessler; S M Mallon; M M Cox; E deMarchena; A Interian; A Castellanos Journal: N Engl J Med Date: 1992-05-28 Impact factor: 91.245
Authors: K Okumura; H Yasue; K Matsuyama; H Ogawa; K Kugiyama; H Ishizaka; H Sumida; H Fujii; T Matsunaga; R Tsunoda Journal: J Am Coll Cardiol Date: 1996-01 Impact factor: 24.094
Authors: S J Eisenberg; M M Scheinman; N K Dullet; W E Finkbeiner; J C Griffin; M Eldar; M R Franz; R Gonzalez; A H Kadish; M D Lesh Journal: Am J Cardiol Date: 1995-04-01 Impact factor: 2.778
Authors: Jonathan S Steinberg; Niraj Varma; Iwona Cygankiewicz; Peter Aziz; Paweł Balsam; Adrian Baranchuk; Daniel J Cantillon; Polychronis Dilaveris; Sergio J Dubner; Nabil El-Sherif; Jaroslaw Krol; Malgorzata Kurpesa; Maria Teresa La Rovere; Suave S Lobodzinski; Emanuela T Locati; Suneet Mittal; Brian Olshansky; Ewa Piotrowicz; Leslie Saxon; Peter H Stone; Larisa Tereshchenko; Mintu P Turakhia; Gioia Turitto; Neil J Wimmer; Richard L Verrier; Wojciech Zareba; Ryszard Piotrowicz Journal: Ann Noninvasive Electrocardiol Date: 2017-05 Impact factor: 1.468
Authors: Acácio F Cardoso; Marco Alexander V Akamine; Rafael M Pessoa; Elizabeth T Takitani; José V Kairiyama; Manfredo K Naritoni Journal: Arq Bras Cardiol Date: 2021-06 Impact factor: 2.000