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Physiopathological considerations on the arterial coronary spasm. Some diagnostic and therapeutical conclusions
Insights
Alkalosis can trigger variant angina by increasing cell calcium, leading to coronary spasms. A new test and acetazolamide treatment show promise in managing this condition.
Area of Science:
- Cardiology
- Physiology
Background:
- Variant angina is characterized by cyclic anginal attacks.
- Coronary arteries have abundant alpha-adrenoceptors.
- Alkalosis may play a role in the pathogenesis of variant angina.
Purpose of the Study:
- To investigate the role of alkalosis in variant angina.
- To introduce a novel method for provoking coronary spasms.
- To present an original therapeutic approach for variant angina.
Main Methods:
- Developed a cold and hyperpnea test to induce coronary spasm.
- Utilized acetazolamide as a therapeutic agent.
- Studied a cohort of 16 patients.
Main Results:
- Demonstrated a link between alkalosis and coronary spasm.
- Successfully provoked spasms using the new test.
- Observed positive outcomes with acetazolamide treatment in initial patient group.
Conclusions:
- Alkalosis contributes to coronary spasm by altering intracellular ion balance.
- The cold and hyperpnea test is effective in provoking spasms.
- Acetazolamide shows potential as a treatment for variant angina.
Abstract:
Starting from the cyclicity of the anginal attack in variant angina, the authors point out the role of alkalosis, besides the richness in alfa-adrenoceptors of the great coronary trunks. At the level of the muscular cell there is a competition between H+-ions and Ca++-ions. The diminution of H+-ions as a result of alkalosis brings about the penetration of Ca++ into the cell and the appearance of the coronary spasm. So, we worked out an original method for the provocation of the spasm (the cold and hiperpneea test) and an original therapeutical procedure (by acetozolamid). We present, herein the first results scored in 16 patients.