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.

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