Coronary spasm and vasomotor dysfunction as a cause of MINOCA

Area of Science:

• Cardiology
• Vascular Biology
• Clinical Medicine

Background:

• Coronary artery spasm and vasomotor dysfunction are increasingly recognized as primary contributors to myocardial infarctions with non-obstructive coronary arteries (MINOCA).
• These conditions are also significant causes of chronic chest pain in patients managed in outpatient settings.
• Understanding these mechanisms is crucial for accurate diagnosis and effective patient management.

Approach:

• This review synthesizes current knowledge on the pathophysiology of coronary artery spasm and vasomotor dysfunction.
• It examines contemporary diagnostic strategies, including invasive and non-invasive methods.
• Evidence-based treatment options, both established and novel, are discussed.

Key Points:

• Coronary artery spasm is implicated in over 50% of MINOCA cases.
• Vasomotor dysfunction contributes significantly to chronic chest pain syndromes.
• Accurate diagnosis relies on a combination of clinical presentation and specialized testing.

Conclusions:

• Effective management of MINOCA and chronic chest pain requires addressing underlying coronary artery spasm and vasomotor dysfunction.
• Current and emerging diagnostic tools are vital for identifying these conditions.
• Evidence-based treatments offer improved prognosis and symptom relief for affected patients.