Variant Angina Pectoris

Abstract

Variant angina pectoris occurred with normal coronary angiograms in a 52-year-old woman. She had the anginal type of discomfort spontaneously at rest or during sleep, but not with exertion; neither was the pain initially provoked by exercise testing. Marked ST-segment elevations accompanied the pain. Ventricular premature beats, ventricular tachycardia and one episode of ventricular fibrillation were recorded. Syncope due to complete heart block associated with the pain required insertion of a transvenous demand pacemaker. No abnormalities of hemoglobin-oxygen dissociation were found. The basis for the variant angina in this patient remains unexplained.