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Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm
Published on: September 17, 2021
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[Coronary spasm a diagnostic and therapeutic challenge]
Hakim Benamer1, Vincent Millien2
1Institut Jacques-Cartier, groupe Ramsay, 6, avenue du Noyer-Lambert, 91300 Massy, France; ICVGVM la Roseraie, 93300 Aubervilliers, France; Hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
Presse Medicale (Paris, France : 1983)
|September 25, 2018
Summary
Vasospastic angina diagnosis is often underestimated, despite its serious risks like sudden death. Improving diagnostic testing sensitivity and routine performance could lead to better recognition and treatment of this coronary artery disease.
Area of Science:
- Cardiology
- Clinical Medicine
Background:
- Vasospastic angina is a recognized clinical entity with potentially severe consequences, including fatal arrhythmias.
- Diagnosis and investigation of vasospastic angina are frequently underestimated in clinical practice.
- The condition has a higher documented incidence in Asia compared to regions like France.
Purpose of the Study:
- To highlight the underdiagnosis of vasospastic angina.
- To emphasize the need for improved diagnostic methods and routine performance of provocative testing.
- To advocate for better recognition of vasospastic angina as a significant coronary disease.
Main Methods:
- Review of clinical and pathophysiological aspects of vasospastic angina.
- Discussion of diagnostic underestimation and current testing practices.
- Proposal for enhanced sensitivity of provocative testing, specifically Ergonovine injection.
Main Results:
- Vasospastic angina can lead to severe arrhythmias and sudden death.
- Provocative testing for vasospastic angina is underutilized and may have suboptimal sensitivity.
- Intracoronary Ergonovine injection is suggested to improve test sensitivity.
Conclusions:
- Increased sensitivity and routine performance of provocative tests are crucial for diagnosing vasospastic angina.
- Improved diagnostic approaches will facilitate appropriate recognition and management of this condition.
- Vasospastic angina, often responsive to medical treatment, warrants greater clinical attention as a coronary disease.
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