ON THE CAUSES OF ANGINA PECTORIS IN PATIENTS WITH PULMONARY EMBOLISM

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. © 2020 Seoul National University. All rights reserved.