Acute myocardial infarction may follow attacks of variant angina, characterized by transient ST-segment elevation and other repolarization ECG changes. Complications of this syndrome are similar to the ones encountered in conventional acute myocardial infarction. Attacks of variant angina occasionally continue after occurrence of myocardial necrosis and often lead to its extension. Myocardial infarction in this setting is often of the nontransmural variety, and ECG occasionally returns to normal a few weeks following onset of illness; therapy at the present is based on nitrates and calcium-antagonists. The role of coronary bypass surgery in the therapy of these patients is as yet unclear. The pathophysiology is at the present speculative, although there are data suggesting that recurrent coronary vasospasm, with or without, secondary thrombosis may be the mechanism transforming a region of reversible ischemia to irreversible necrosis.
|Number of pages||9|
|Journal||British Journal of Clinical Practice|
|State||Published - 1982|