Related Experiment Video

Updated: Jun 27, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

[Clinical features of coronary artery spasm patients with or without myocardial bridge]

Ding-Cheng Xiang1, Jian-Xin He, Yun-Jun Ruan

  • 1Department of Cardiology, Guangzhou General Hospital of Guangzhou Command, Guangzhou 510010, China. dcxiang@yahoo.com.cn

Zhonghua Xin Xue Guan Bing Za Zhi
|December 23, 2008
PubMed

Insights

Patients with myocardial bridge (MB) are more prone to coronary artery spasm, potentially due to endothelial dysfunction. These patients often present with distinct clinical symptoms and positive stress test results for ischemia.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Testing

Context:

  • Coronary artery spasm (CAS) is a significant cause of angina.
  • Myocardial bridging (MB) is a congenital anomaly where a segment of the coronary artery is partially covered by heart muscle.
  • The relationship between MB, CAS, and endothelial function remains incompletely understood.

Purpose:

  • To compare the clinical features of patients with coronary artery spasm (CAS) with and without myocardial bridging (MB).
  • To investigate the role of endothelial dysfunction in patients with CAS, stratified by the presence or absence of MB.
  • To evaluate diagnostic test results in these patient groups.

Summary:

  • A study compared 26 patients with MB and 92 without MB, all undergoing acetylcholine provocation tests.
  • Patients with MB showed higher rates of induced coronary artery spasm (81% vs. 57%), positive exercise ECG (73% vs. 8%), and perfusion defects (77% vs. 10%).
  • MB patients exhibited higher endothelin-1 and lower nitric oxide levels, indicating endothelial dysfunction, and presented with distinct angina patterns.

Impact:

  • This research highlights that myocardial bridging may predispose individuals to coronary artery spasm, partly mediated by endothelial dysfunction.
  • Findings suggest that patients with MB and CAS exhibit specific clinical manifestations and diagnostic findings.
  • Understanding these differences can aid in the diagnosis and management of coronary artery spasm in patients with myocardial bridging.
Abstract

More Related Videos

Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm06:18

Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm

Published on: September 17, 2021

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

Published on: February 3, 2021

Related Concept Videos

Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Angina I: Introduction01:30

Angina I: Introduction

Definition and Symptoms: Angina (angina pectoris) is chest pain or discomfort caused by myocardial ischemia, which occurs when the heart muscle receives insufficient oxygen-rich blood. It typically manifests as pressing, squeezing, or crushing sensations in the chest and may radiate to the shoulders, arms, neck, jaw, or back.Primary Cause: In a healthy state, the coronary arteries can dilate (widen) to increase blood flow and meet the increased oxygen demand during physical activity or...