Related Experiment Video

Updated: May 16, 2025

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
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Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

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Vasospastic Angina as a Cause of Post-Acute Sequelae of COVID-19

Tadao Aikawa1,2,3, Jiro Ogino4, Naohiro Funayama2

  • 1Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine.

International Heart Journal
|May 14, 2025
PubMed

Insights

Diagnosing chest pain in long COVID patients can be difficult. This study suggests vasospastic angina may be a potential cause of this chest pain in some post-acute sequelae of COVID-19 patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pulmonology

Background:

  • Post-acute sequelae of COVID-19 (PASC), or long COVID, presents complex diagnostic challenges, particularly for chest pain in patients without high pre-test probability for coronary artery disease.
  • Cardiovascular manifestations of PASC require further investigation to understand their underlying mechanisms and clinical impact.

Purpose of the Study:

  • To investigate the potential role of vasospastic angina (VSA) as a cause of chest pain in patients with PASC.
  • To evaluate the diagnostic yield of acetylcholine provocation testing in this specific patient population.

Main Methods:

  • Retrospective review of 273 consecutive patients presenting with cardiovascular PASC.
  • Acetylcholine provocation testing was performed on 8 patients suspected of having VSA.

Main Results:

  • Five out of 273 patients (1.8%) were newly diagnosed with VSA.
  • VSA was identified as a potential cause of chest pain in a small subset of patients with PASC.

Conclusions:

  • Vasospastic angina (VSA) may be an underrecognized cause of chest pain in patients experiencing post-acute sequelae of COVID-19 (PASC).
  • Further research is warranted to elucidate the causal relationship between VSA and PASC and its clinical implications.

Keywords:
Coronary microvascular dysfunctionLong COVID

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