Effort Angina Without Coronary Obstruction in a Patient with Takayasu's Aortitis: A Case Report

Ochiai, Jun; Kanaide, Hideo; Okamatsu, Shuichi; Yamada, Akira; Nakamura, Motoomi
July 1985
Angiology;Jul1985, Vol. 36 Issue 7, p465
Academic Journal
Angina occurring in patients with Takayasu's aortitis is attributed to the narrowing of the coronary ostium and/or aortic regurgitation. We treated a patient with Takayasu's aortitis with effort angina, in whom there was no obstruction of the ostium or aortic regurgitation. Treadmill exercise stress test revealed significant ST depression in leads V4�6, II, III and aVF with chest pain. Examinations of lactate in coronary sinus as well as arterial blood suggested the occurrence of myocardial ischemia during atrial pacing. The DPTI/TTI index was decreased and the left ventricular end-diastolic pressure was increased during angina. It is considered that the reduced coronary perfusion pressure resulted from a low diastolic aortic pressure and the elevated left ventricular end-diastolic pressure decreased the DPTI/TTI index and contributed to the development of subendocardial ischemia.


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