Elevation of left ventricular end-diastolic pressure due to decreased myocardial compliance during angina pectoris.

The etiology for the increased left ventricular end-diastolic pressure (LVEDP), which is frequently seen during angina pectoris, remains controversial. Although left ventricular failure may be present, recent evidence suggests that a decrease in myocardial compliance may be involved. The patient reported here developed a rise in LVEDP when angina was precipitated by atrial pacing. Hemodynamic data during and after pacing showed normal left ventricular function and indicates that a decrease in myocardial compliance should have occurred.