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Published on: August 18, 2016
Coronary artery spasm: review and update
Ming-Jui Hung1, Patrick Hu2, Ming-Yow Hung3
11. Department of Cardiology, Chang Gung Memorial Hospital, Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan;
Insights
Coronary artery spasm (CAS) causes severe vasoconstriction, leading to myocardial ischemia. Diagnosis requires angiography and provocative tests, with calcium antagonists as the primary treatment.
Area of Science:
- Cardiology
- Vascular Biology
- Ischemic Heart Disease
Background:
- Coronary artery spasm (CAS) involves intense vasoconstriction of coronary arteries, causing vessel occlusion and contributing to myocardial ischemic syndromes.
- CAS is implicated in conditions such as stable and unstable angina, acute myocardial infarction, and sudden cardiac death.
- The underlying mechanisms of CAS are not fully understood, and it is not associated with traditional coronary artery disease risk factors.
Purpose of the Study:
- To review the current literature on coronary artery spasm.
- To summarize the existing knowledge regarding the pathogenesis of CAS.
- To highlight the diagnostic and therapeutic implications of CAS.
Main Methods:
- Literature review of studies on coronary artery spasm.
- Synthesis of current knowledge on CAS pathogenesis.
- Analysis of diagnostic criteria and treatment strategies.
Main Results:
- CAS is a significant cause of myocardial ischemic syndromes.
- Definitive diagnosis typically requires coronary angiography and provocative testing.
- CAS is multifactorial and independent of traditional cardiovascular risk factors.
Conclusions:
- Calcium antagonists are the cornerstone of medical treatment for CAS, unlike beta-blockers.
- While generally considered benign, recurrent angina episodes are common in patients with CAS.
- Further research into the pathogenesis of CAS is warranted.
Abstract:
Coronary artery spasm (CAS), an intense vasoconstriction of coronary arteries that causes total or subtotal vessel occlusion, plays an important role in myocardial ischemic syndromes including stable and unstable angina, acute myocardial infarction, and sudden cardiac death. Coronary angiography and provocative testing usually is required to establish a definitive diagnosis. While the mechanisms underlying the development of CAS are still poorly understood, CAS appears to be a multifactorial disease but is not associated with the traditional risk factors for coronary artery disease. The diagnosis of CAS has important therapeutic implications, as calcium antagonists, not β-blockers, are the cornerstone of medical treatment. The prognosis is generally considered benign; however, recurrent episodes of angina are frequently observed. We provide a review of the literature and summarize the current state of knowledge regarding the pathogenesis of CAS.
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