Coronary Spasm

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Coronary spastic angina; Variant angina; Vasospastic angina; Prinzmetal angina

Definition and Characteristics

Coronary spasm is defined as a dynamic and transient reduction in the luminal diameter of epicardial coronary arteries due to increased vasomotor tone, leading to myocardial ischemia. It was first reported as variant angina by Prinzmetal et al. [1], who demonstrated reversible myocardial ischemia accompanied by ST segment elevation on the electrocardiogram (ECG). At present, it is believed that coronary spasm plays an important role in the pathogenesis of not only variant angina but ischemic heart disease as well, including other forms of angina, acute myocardial infarction, and ischemic sudden death. In general, patients with coronary spasm are younger than those with organic coronary stenosis and cigarette smoking is considered to be a major risk factor for coronary spasm. Typically, there is a circadian variation with an increased ...