[A study on normal coronary arteriogram by provocation and spontaneous anginal attack: 4 cases of ST elevated angina with normal coronary arteries by provoked and spontaneous attacks].

During 3 years and 5 months, we experienced 3 of 172 cases of provocations on normal coronary arteries which presented ST elevated angina by ergonovine provocations. The incidence was 2.5% and 4% for all ergonovine provocations and intracoronary ergonovine provocations respectively. One case presented spontaneous attack in coronary arteriography, indicating similar state to occur not only with provocation but also in spontaneous attack. Examination of literature revealed no apparent report on such cases as this. For pathogenesis, the possibility of changes of small vessels was suggested in view of various literature and its specificity to the coronary arterial region.