Coronary bypass surgery in Prinzmetal angina.

A case of Prinzmetal angina, characterized by spontaneous attacks of chest pain associated with hypotension, inferior wall ST-segment elevation, and transient second degree A-V block, is presented in which coronary arteriography demonstrated spasm of the right coronary artery. Aortocoronary bypass surgery, a questionable approach in the treatment of this entity, afforded complete symptomatic relief. The multiple problems inherent in selecting patients and proper operative technique are discussed.