Coronary Artery Spasm as a Cause of Angina
Coronary vasoconstriction has moved in and out of fashion for over a century. The initial descriptions of angina considered vasomotor instability as a key mechanism1, but pathological studies2 and the invention of coronary angiography in the middle of last century, focused attention on structural stenoses and occlusions due to atheromatous plaques. When Prinzmetal described a variant form of angina3, which was later confirmed as coronary spasm4, vasomotor instability returned to the limelight. Variant angina is characterized by symptoms at rest (not exertion) with ST elevation on ECG (not depression). It usually occurs in the early hours of the morning during depressed vagal tone, and is associated with occlusion or near occlusion (>90% stenosis) of a focal proximal coronary segment on angiography.
- coronary microvascular function
- coronary spasm
- coronary spastic angina
- coronary vasomotor dysfunction
- Received February 13, 2014.
- Accepted February 21, 2014.