ABSTRACT.In 27 patients (pts.) with a history of exercise induced angina pectoris coronary heart disease (CHD), hypertrophic or congestive cardiomyopathy and mitral valve prolapse were excluded by coronary and left ventricular angiography and echocardiography. The pts. were divided into two subgroups: 12 pts. with normal (groups A) and 15 pts. with abnormal exercise ECG (group B). All but two pts. showed a positive reaction on nitroglycerin. The results of a retrospective analysis of clinical and hemodynamic findings are reported. No age differences were detected. There was an over‐representation of females in group B (12:3). In group B ST‐depression (0,1 − 0,3 mV) during exercise and angina occured in 4 pts., in the remainder only ST‐depression between 0,1 and 0,3 mV was observed. At submaximal exercise (mean in group A 75 watt, group B 82 watt) in both groups left ventricular enddiastolic pressure (LVEDP) and\ or mean pulmonary artery pressure (PAP) increased to abnormal values. The main difference between the two groups beyond the ST‐segment reaction with exercise was the difference in enddiastolic volume indices (EDVI): 74±15 in group A and 90±16 ml/m2in group B. By these findings exercise induced angina in absence of CHD can occur with two different patterns both showing pathologic LVEDP values with exercise: type A with normal exercise ECG and normal LV volumes, type B with abnormal exercise ECG and borderline or abnormal EDVI, increase of end‐systolic volume index during exercise and constant stroke volume index during rest and exercise. The positive effect of nitroglycerin in both groups can be explained by the reduction of elevated LVEDP during exercise. The etiology of this type of left ventricular compliance disorder is unknown. Long term therapy with isosorbiddinitrate should be discussed in spite of absence of coronary