American Journal of Cardiovascular Drugs

, Volume 10, Supplement 2, pp 19–26

Coronary Vasospasm: Is it a Myth?

  • Udo Sechtem
  • Peter Ong
  • Anastasios Athanasiadis
  • Matthias Vöhringer
  • Rimma Merher
  • Ali Yilmaz
Review Article

DOI: 10.2165/1153642-S0-000000000-00000

Cite this article as:
Sechtem, U., Ong, P., Athanasiadis, A. et al. Am J Cardiovasc Drugs (2010) 10(Suppl 2): 19. doi:10.2165/1153642-S0-000000000-00000

Abstract

This review addresses some myths about coronary vasospasm as the cause of angina pectoris. Coronary artery vasospasm is a common phenomenon, which is clinically encountered by busy cardiologists almost on a daily basis. It is the cause of resting angina in many patients without significant coronary artery disease, but also in patients with atherosclerotic coronary artery disease but no subtotal lesion. Although coronary artery vasospasm can be suspected clinically, proof cannot usually be obtained by non-invasive means but is easily available during cardiac catheterization. Patients with vasospastic angina are repeatedly exposed to this invasive procedure as most cardiologists suspect a coronary lesion requiring intervention as the cause of the patient’s resting angina. Adding an intracoronary acetylcholine test to the catheterization procedure may establish the correct diagnosis and enable treatment with calcium antagonists and nitrates. Epicardial vasospasm may be observed during the test in patients with and without angiographically visible lesions in the coronary arteries. Almost 50% of all pathological tests, however, do not show epicardial vasospasm but reproduction of symptoms and electrocardiogram signs of ischemia indicating spasm of the microvessels.

Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • Udo Sechtem
    • 1
  • Peter Ong
    • 1
  • Anastasios Athanasiadis
    • 1
  • Matthias Vöhringer
    • 1
  • Rimma Merher
    • 1
  • Ali Yilmaz
    • 1
  1. 1.Department of CardiologyRobert-Bosch-KrankenhausStuttgartGermany