[Role of the vasospastic factor in stenocardia in ischemic heart disease].

Selective coronarography and pharmacological test with intravenous administration of ergometrin have been carried out in 100 patients. The test permits one to demonstrate the vasospastic form of angina pectoris, which is encountered in patients with different degrees of lesions of the coronary arteries and different tolerance to exercise. Lack of coincidence in localization of ischaemic zones in the myocardium in tests with exercise and intravenous injection of ergometrin according to myocardium scintigraphy with 201Tl points to the possibility of existence of two forms of angina pectoris in the same patient, differing not only in the pathogenetic mechanisms but also in the localization of the ischaemic changes supervening in the myocardium. According to the data of echocardiography during the anginal attack with rise of the ST segment there is a more pronounced dilatation of the left ventricle cavity and decrease of the myocardial contractility than in the anginal attack with depression of the ST segment. In patients with spontaneous angina pectoris and rise of the ST segment corinfar exerted marked antianginal effect. Inderal was ineffective. In patients with angina pectoris and depression of the ST segment there was no difference between the two drugs.