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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
PubMed

Insights

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.

Keywords:
Coronary spasmPrintzmetal anginaVariant angina

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