Provocative Testing for Coronary Reactivity and Spasm

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Provocative testing for coronary reactivity and spasm.

Coronary spasm is an important and often overlooked etiology of chest pain. Although coronary spasm, or Prinzmetal's angina, has been thought of as benign, contemporary studies have shown serious associated adverse outcomes, including acute coronary syndrome, arrhythmia, and death. Definitive diagnosis of coronary spasm can at times be difficult, given the transience of symptoms. Numerous agent...

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A renaissance of provocative testing for coronary spasm?

The term variant angina, first used by Prinzmetal et al. (1) in 1959, denotes chest discomfort with classic features of angina but occurring at rest or at night (usually the early morning hours) rather than with exertional or emotional stress. The pain is often associated with ST segment elevation and is relieved by nitroglycerin. A female predominance and frequent association with cigarette sm...

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Vitamin C attenuates abnormal vasomotor reactivity in spasm coronary arteries in patients with coronary spastic angina.

OBJECTIVES This study sought to examine effect of vitamin C, an antioxidant, on the abnormal vasomotor reactivity in spasm coronary arteries. BACKGROUND Oxygen free radicals generated in the arterial walls have been shown to cause endothelial vasomotor dysfunction. METHODS Responses of the epicardial arterial diameters of the left coronary arteries to the intracoronary infusion of acetylcho...

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Provoked coronary spasm and acute coronary syndromes.

lthough coronary artery spasm (CAS) has been linked ith acute coronary syndromes (ACS) and vulnerable laque (1), thrombosis (2), percutaneous coronary intervenion (PCI), and stenting (3–7), very limited attention is iven to CAS in the current era. This may be related to ssumptions that the frequency of CAS is decreasing and if resent it will be eliminated with calcium antagonist (8) or itrate u...

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To examine whether acute myocardial ischemia activates the coagulation system and platelet activation in the coronary circulation, we measured plasma levels of fibrinopeptide A and j3-thromboglobulin in the coronary sinus and the aortic root simultaneously in 15 patients with coronary spastic angina before and after the left coronary spasm induced by intracoronary injection of acetylcholine and...

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ژورنال

عنوان ژورنال: Journal of the American College of Cardiology

سال: 2014

ISSN: 0735-1097

DOI: 10.1016/j.jacc.2013.10.038