Direct arterial pressure and the electrocardiogram in unrestricted patients with angina pectoris

Abstract

Direct arterial pressure and electrocardiogram was recorded over a 24 hr period in 8 males with angina pectoris who were completely unrestricted throughout the study. Twenty five separate episodes of angina occurred, precipitated by exertion, eating, smoking, and anxiety, in addition to 2 spontaneous attacks and 2 episodes of nocturnal angina. All but 2 angina episodes were accompanied by a rise in both arterial pressure and heart rate. In the cases of spontaneous and nocturnal angina these pressure and rate changes began 10-15 min before the pain. In exertional angina these changes were related to the degree of activity involved, while in other instances there was a brief surge of pressure and rate occurring at the time of onset of pain. In each patient pain tended to occur at approximately the same level of pressure rate product. ST segment changes in the electrocardiogram showed no consistent pattern, occurring before or after the onset of pain, while in some episodes there was no significant change. A limited number of observations were made on the effect of glyceryl trinitrate and β adrenergic receptor blocking drugs.