[Changed views on vasoconstriction of coronary vessels and angina pectoris]

Views on the impact spasms of the coronary arteries (in the work of distinguished internists and cardiologists) changed in recent years. At present it is obvious that even coronaries damaged by atherosclerosis (in particular eccentric stenoses) may react to vasoconstrictor stimuli by a spasm and this promotes various manifestations of ischaemic heart disease. The coronary arteries can respond by vasoconstriction to stimuli to which arteries without atherosclerotic changes react by vasodilatation. Hypolipidaemic treatment reduces not only stenoses of the coronaries but improves also their impaired vasomotorics. A spasm of a "sound" artery remains an exceptional occurrence. This, however, casts no doubts on the importance of the serious character of organic stenoses and the increase of cardiac work which causes ischaemia of the heart muscle.