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Coronary spasm during selective coronary angiography have multiple explanation. In some instances there is no true pathological implication (catether induced spasm), in other instances, instead, a clear relationship with "functional" angina and myocardial infarction exists. Moreover, in few occasions may only be a false positive radiologic image (apparent spasm). The angiographic features of coronary spasm, however, are always the same, indipendently from its clinical significance and pathophysiologic mechanism. In this paper the Authors are not limiting their experience to the morphologic description of this event, rather describe the clinical criteria which, together with angiographic picture, may be useful in the interpretation of the physiopathology of the coronary artery spasm.

One thousand coronary arteriography performed in the catheterization laboratory of the Department of Cardiology (University of Padua) from 1973 to 1978 were reviewed. Indication to perform a coronary arteriography was established in 668 patients with clinically suspected coronary artery disease and in 332 patients affected by different heart disease in whom the study of coronary arteries was judged to be usefull. The percutaneous technique was usually employed. The overall mortality rate was 0.2%; there were no death in the last three years. The overall morbility was 3.5% (2.3 from 1976 to 1978). The anterior descending artery appeared to be the most frequently and precociously affected area. There was a good correlation between severity of the atherosclerotic lesions and age or sex of the patients. We could recognize coronary disease, when present, on the basis of clinical evaluation in patients without different heart disease.