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August 1974

Bypass Surgery for Prinzmetal Angina

Author Affiliations


From the Department of Cardiology, Albert Einstein Medical Center, Philadelphia. Dr. Bentivoglio is currently with the Division of Cardiology, Medical College of Pennsylvania, Philadelphia.

Arch Intern Med. 1974;134(2):313-316. doi:10.1001/archinte.1974.00320200123017

Prinzmetal angina is a clinical-electrocardiographic syndrome characterized by attacks of angina pectoris unrelated to exercise and occurring frequently after meals or during the night. They last minutes to hours, often with a predictable daily pattern, and show a pathognomonic ECG consisting of ST segment elevation (rather than depression) during the attack, in the leads facing the region of myocardial ischemia.1 Myocardial irritability and conduction disturbances are common during the attack.

A review of the accessible literature shows that at least 111 cases have been reported.1-44 Myocardial infarction and death are frequent complications. Of the 90 patients in whom pertinent information was given, 22 developed acute myocardial infarction1,4,5,7,8,10,13,20,32,35,36 within months after the onset of attacks was stated, with one subsequent death20; 13 others died suddenly, often within months after onset1,3,6,14,16,22,23,27,29,36 -a combined incidence of 39%. In 21 of the 23 patients studied by selective coronary arteriography,