Key result
Undiagnosed coronary vasospasm drives myocardial ischemia and can precipitate MI and malignant ventricular arrhythmias.
Coronary vasospasm is an underrecognized cause of myocardial ischemia that can precipitate malignant ventricular arrhythmias and sudden cardiac arrest if unrecognized.
Prompts consideration of vasospasm testing in unexplained arrhythmias; extends RCT evidence for targeted prevention.
Vasospastic angina is an underrecognized cause of myocardial ischemia characterized by transient coronary artery spasm and a wide spectrum of clinical presentations.1 Symptoms may be atypical, intermittent, or nocturnal, often mimicking noncardiac conditions or other arrhythmogenic syndromes, which can delay diagnosis. When unrecognized, coronary vasospasm may precipitate myocardial infarction, malignant ventricular arrhythmias, syncope, or sudden cardiac arrest.1 Diagnosis can be challenging and may require provocative testing or demonstration of dynamic ischemic changes, while management focuses on trigger avoidance, risk factor modification, and vasodilator therapy.
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Shtembari et al. (2026) conducted a review in Coronary Vasospasm. Coronary vasospasm is an underrecognized cause of myocardial ischemia that can precipitate myocardial infarction and malignant ventricular arrhythmias if left undiagnosed.
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