THE HYPERVENTILATION TEST - A NONINVASIVE FIRST TEST IN WORK-UP OF SUSPECTED VASOSPASTIC ANGINA-PECTORIS

3 patients with coronary vasospasms in different clinical situations a re presented. One patient had typical Prinzmetal angina but coronary a rteries without significant stenosis. One patient without typical angi na pectoris showed sudden significant ST elevations on anterior and la teral ECG tracings accompanied by typical ischemic chest pain. At angi ography, a 70% LAD stenosis was found without high degree lesions. One patient (aged 30 years) had a documented anterior infarction with ang iographically normal coronary arteries. In all these cases coronary va sospasms were recognized as the underlying cause of the symptoms. All the patients were treated with calcium channel blockers and have been asymptomatic since. Currently available data comparing the diagnostic value of hyperventilation with other tests for coronary vasospasms, su ch as ergonovine or acetylcholine, are discussed. The hyperventilation test can be recommended as the first test in the work up of suspected vasospastic angina pectoris.