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On the Causes of Angina Pectoris in Patients With Pulmonary Embolism

https://doi.org/10.18087/cardio.2020.1.n729

Abstract

Objective Compare the distance between the pulmonary artery (PA) and the left coronary artery (LCA) using pulmonary angiography and the rate of detection of the signs of left ventricular myocardial ischemia
in the first electrocardiogram (ECG) in pulmonary embolism (PE) patients with or without angina to detect possible causes of angina pectoris.
Material and Methods Measurement of the minimum distance between the PA and LCA in multislice spiral computed tomography and analysis of the first ECG were performed in 55 PE patients. 15 (27.3%) patients had angina pectoris at the onset of the disease.
Results Angina pectoris was observed in 14 (93.3%) of 15 patients with the distance between the PA and
LCA less than 4.3 mm, and in one (2.5%) of 40 patients with the distance between these vessels equal
to or exceeding the specified value (p<0.001). In the first ECG, the ST elevation in the aVR lead was
detected in 10 (66.7%) patients with angina pectoris, and only in 3 (7.5%) patients without angina
pectoris (p<0.001).
Conclusions The findings suggest that angina pectoris in acute pulmonary embolism may be caused by compression of the LCA by the dilated PA.

About the Authors

E. S. Mazur
Tver State Medical University
Russian Federation
Tver


V. V. Mazur
Tver State Medical University
Russian Federation
Tver


R. M. Rabinovich
Tver Regional Clinical Hospital
Russian Federation
Tver


K. S. Myasnikov
Tver Regional Clinical Hospital
Russian Federation
Tver


M. A. Bachurina
Tver Regional Clinical Hospital
Russian Federation
Tver


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Review

For citations:


Mazur E.S., Mazur V.V., Rabinovich R.M., Myasnikov K.S., Bachurina M.A. On the Causes of Angina Pectoris in Patients With Pulmonary Embolism. Kardiologiia. 2020;60(1):28-34. https://doi.org/10.18087/cardio.2020.1.n729

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