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Related Concept Videos

Vascular Spasm01:16

Vascular Spasm

The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last for...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...

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Coronary vasospasm: A narrative review.

Jacob Jewulski1, Sumesh Khanal2, Khagendra Dahal3

  • 1Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, United States.

World Journal of Cardiology
|October 8, 2021
PubMed
Summary

Coronary artery vasospasm (CAVS) causes acute chest pain. Research is ongoing to understand its causes, diagnosis, and treatments beyond current calcium channel blockers and nitrates.

Keywords:
Coronary artery diseaseCoronary artery vasospasmPrinzmetal anginaVariant anginaVasospastic angina

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Area of Science:

  • Cardiology
  • Vascular Biology

Background:

  • Coronary artery vasospasm (CAVS) is a key factor in acute chest pain syndrome.
  • Autonomic and endothelial dysfunction are implicated in CAVS pathophysiology.
  • Prevalence varies, with higher rates in East Asian and female populations.

Purpose of the Study:

  • To review the current understanding of coronary artery vasospasm.
  • To highlight diagnostic challenges and emerging non-invasive methods.
  • To discuss current and future treatment strategies for CAVS.

Main Methods:

  • Review of existing literature on coronary artery vasospasm.
  • Analysis of diagnostic modalities, including provocative testing and biomarkers.
  • Evaluation of therapeutic interventions and risk factor modification.

Main Results:

  • CAVS pathophysiology involves autonomic and endothelial dysfunction.
  • Smoking is a risk factor, but CAVS differs from traditional coronary artery disease.
  • Chemotherapeutics, allergens, and inflammatory mediators are identified triggers.
  • Provocative testing is the gold standard for diagnosis; non-invasive tests are under investigation.
  • Calcium channel blockers are first-line treatment, with nitrates as adjuncts.
  • Implantable cardioverter defibrillators (ICDs) are considered for high-risk patients.

Conclusions:

  • Further research is needed to fully elucidate CAVS pathophysiology and optimize treatment.
  • Non-invasive diagnostic tools and targeted therapies, including those for oxidative stress, require further investigation.
  • Risk factor modification and appropriate medical therapy are crucial for managing CAVS.