Unstable angina with tachycardia: clinical and therapeutic implications
Short Title: 
Unstable angina with tachycardia

We prospectively evaluated 19 patients with prolonged chest pain not evolving to myocardial infarction and accompanied with reversible ST-T changes and tachycardia (heart rate greater than 100 beats/min) in order to correlate heart rate reduction with ischemic electrocardiographic (ECG) changes. Fourteen patients (74%) received previous long-term combined treatment with nifedipine and nitrates. Continuous ECG monitoring was carried out until heart rate reduction and at least one of the following occurred: (1) relief of pain or (2) resolution of ischemic ECG changes. the study protocol consisted of carotid massage in three patients (16%), intravenous propranolol in seven patients (37%), slow intravenous amiodarone infusion in two patients (10%), and intravenous verapamil in four patients (21%) with atrial fibrillation. In three patients (16%) we observed a spontaneous heart rate reduction on admission. Patients responded with heart rate reduction from a mean of 125 +/- 10.4 beats/min to 84 +/- 7.5 beats/min (p less than 0.005) and an ST segment shift of 4.3 +/- 2.13 mm to 0.89 +/- 0.74 mm (p less than 0.005) within a mean interval of 13.2 +/- 12.7 minutes. Fifteen (79%) had complete response and the other four (21%) had partial relief of pain. A significant direct correlation was observed for heart rate reduction and ST segment deviation (depression or elevation) (r = 0.7527 and 0.8739, respectively). These patients represent a unique subgroup of unstable angina, in which the mechanism responsible for ischemia is excessive increase in heart rate. Conventional vasodilator therapy may be deleterious, and heart rate reduction in mandatory.

Sclarovsky, S.
Bassevich, R.
Strasberg, null
Klainman, E.
Rechavia, E.
Sagie, A.
Agmon, J.
Item Type: 
Journal Article
Publication Title: 
American Heart Journal
Journal Abbreviation: 
Am. Heart J.
Publication Date: 
Nov 1988
Publication Year: 
5 Pt 1
Library Catalog: 
NCBI Published Medical (?)
PMID: 3189136

Turabian/Chicago Citation

S. Sclarovsky, R. Bassevich, null Strasberg, E. Klainman, E. Rechavia, A. Sagie and J. Agmon. Nov 1988. "Unstable angina with tachycardia: clinical and therapeutic implications." American Heart Journal 116: 5 Pt 1: 1188-1193.

Wikipedia Citation

<ref> {{Cite journal | doi = | issn = 0002-8703 | volume = 116 | pages = 1188-1193 | last = Sclarovsky | first = S. | coauthors = Bassevich, R., Strasberg, null, Klainman, E., Rechavia, E., Sagie, A., Agmon, J. | title = Unstable angina with tachycardia: clinical and therapeutic implications | journal = American Heart Journal | date = Nov 1988 | pmid = | pmc = }} </ref>