Multivessel coronary spasm as a cause of ischemic syncope in angina at rest*.

Two patients with vasospastic angina at rest developed ST segment elevation both in the anterior and inferior leads during spontaneous and ergonovine-induced attacks. In both cases the acute myocardial ischemia secondary to multivessel coronary spasm led to reversible electromechanical dissociation. Coronary arteriography showed normal coronary arteries in one case and severe three-vessel disease in the other; spasm of the right coronary artery was demonstrated in both patients. These cases show that in patients with vasospastic angina coronary spasm may simultaneously involve different arteries and lead to ischemic electromechanical dissociation. Ergonovine testing is contraindicated in those patients with suspected or proved multivessel coronary spasm. [ABSTRACT FROM PUBLISHER]