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. 2010 Feb 26;2(2):34-42.
doi: 10.4330/wjc.v2.i2.34.

Current advances in the understanding of coronary vasospasm

Ming-Jui Hung  1
Affiliations

Current advances in the understanding of coronary vasospasm

Ming-Jui Hung. World J Cardiol. .

Abstract

Recent years have witnessed progress in our understanding of coronary vasospasm (CVS). It is evident that this is not only an East Asian but also a global disease associated with significant symptoms and possible lethal sequelae for afflicted individuals. A correct diagnosis depends on the understanding of pathogenesis and symptomatology of CVS. With the correct diagnosis, we can manage CVS patients effectively and promptly, providing optimal patient safety. Advances in our understanding of interactions between inflammation, endothelium, and smooth muscle cells have led to substantial progress in understanding the pathogenesis of symptoms in CVS and have provided some insights into the basic etiology of this disorder in some patient subpopulations. We look forward to a time when therapy will address pathophysiology and perhaps, even the primary etiology.

Keywords: Coronary vasospasm; Endothelial nitric oxide synthase; Inflammation; Nitric oxide; Rho-kinase.

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Figures

Figure 1
Figure 1
Baseline electrocardiography (ECG) of a patient with variant angina. A: The ECG showed no evidence of myocardial ischemia on admission to the emergency department; B: A few hours later, the follow-up ECG, due to chest pain, showed ST-segment elevation in the V2-4 leads. C: During the following days, serial ECGs due to chest pain showed dynamic ST-segment elevation in the anterior and inferior leads. D: The patient’s ECG was normal when he was not having chest pain. Baseline coronary angiography showed no evidence of significant fixed coronary artery stenosis; E: Diffuse spasm in the proximal to distal portion (white arrows) and diagonal branch (black arrow) of the left anterior descending artery and in the proximal portion of the left circumflex artery (arrowhead) were noted following intracoronary methylergonovine administration.
See this image and copyright information in PMC

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