Intermediate Coronary Syndrome

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Abstract
The existence of a state of prolonged but reversible myocardial ischemia, clinically intermediate between angina pectoris and acute myocardial infarction, is confirmed on the basis of clinical, instrumental and pathological evidence. A clinico-electrocardiographic analysis is presented of 251 cases of "intermediate coronary syndrome" observed over a 10-year period. Most of the cases had "infarction-like" or "angina-like" pains of moderate severity, insignificant alterations of pulse rate and blood pressure, little or no rise in temperature and no evidence of shock, congestive heart failure or gross myocardial necrosis. Characteristic ecg patterns of myocardial ischemia, in the form of marked "trough-like" S-T segment depressions, shallow or deep inversions of T waves, or coving of ST segments with abnormal T waves, were observed in all cases. Ninety-one of the cases developed acute myocardial infarction within 3 months of the initial attack of pain. The present study serves to confirm the existence of a distinct and recognizable clinico-electrocardiographic entity of "intermediate" or "pre-infarction" "coronary syndrome".