Coronary Artery Spasm as a Cause of Angina.
Circulation. 2014 Feb 26;
Authors: Kinlay S
Coronary vasoconstriction has moved in and out of fashion for over a century. The initial descriptions of angina considered vasomotor instability as a key mechanism(1), but pathological studies(2) 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 angina(3), which was later confirmed as coronary spasm(4), 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.
PMID: 24573350 [PubMed - as supplied by publisher]