Physiopathological considerations on the arterial coronary spasm. Some diagnostic and therapeutical conclusions.

Starting from the cyclicity of the anginal attack in variant angina, the authors point out the role of alkalosis, besides the richness in alfa-adrenoceptors of the great coronary trunks. At the level of the muscular cell there is a competition between H+-ions and Ca++-ions. The diminution of H+-ions as a result of alkalosis brings about the penetration of Ca++ into the cell and the appearance of the coronary spasm. So, we worked out an original method for the provocation of the spasm (the cold and hiperpneea test) and an original therapeutical procedure (by acetozolamid). We present, herein the first results scored in 16 patients.