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Coronary artery spasm: Current knowledge and residual uncertainties.
Massimo Slavich1,2, Riyaz Suleman Patel1,3
1Dept. of Cardiology, The Heart Hospital, University College London NHS Trust, London, UK.
International Journal of Cardiology. Heart & Vasculature
|June 16, 2017
Summary
Coronary spasm can cause sudden cardiac death and myocardial infarction, even without visible blockages. This review discusses diagnosis, treatment, and management strategies for high-risk patients to prevent premature death.
Area of Science:
- Cardiology
- Vascular Medicine
- Pathophysiology
Background:
- Myocardial ischemia typically stems from supply-demand mismatch due to atherosclerosis or thrombosis.
- Coronary spasm presents as transient ischemia without apparent coronary pathology.
- Coronary spasm can lead to severe outcomes including infarction, LV dysfunction, arrhythmias, and sudden cardiac death.
Purpose of the Study:
- To address common questions surrounding coronary spasm.
- To review evidence for pharmacological treatment of coronary spasm.
- To discuss strategies for identifying and managing high-risk patients to reduce sudden cardiac death.
Main Methods:
- Literature review focusing on diagnosis, pathology, and management of coronary spasm.
- Exploration of pharmacological treatment options.
- Discussion of risk stratification and management for high-risk individuals.
Main Results:
- Coronary spasm is a significant cause of acute myocardial ischemia.
- Controversies persist regarding diagnosis, pathology, and management.
- Evidence for pharmacological treatments and risk reduction strategies is examined.
Conclusions:
- Coronary spasm requires careful consideration due to its potential for severe outcomes.
- Further research and standardized approaches are needed for optimal diagnosis and management.
- Effective strategies can mitigate the risk of sudden cardiac death in affected patients.
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