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Design
Review
May inform broader differentials for symptomatic CAD; leaves open prospective studies on non-atherosclerotic mechanisms.
he field of coronary artery pathology is overwhelmingly dominated by one diseaseatherosclerosis. It is therefore not surprising that insight into the onset of symptomatic coronary artery diseases mainly stems from patients with plaques. Coronary atherosclerosis may lead to relatively benign symptoms, such as stable angina, due to bare stenosis or restenosis of lesions. Life threatening symptoms (unstable angina, myocardial infarction or sudden cardiac death (SCD)) usually arise from plaque disruption and superimposed thrombosis, whereas additional arterial spasm or microembolisation of atherothrombotic materials may worsen the situation. But many non-atherosclerotic coronary diseases may become symptomatic due to similar flow limiting complications, which is clearly of importance for differential diagnosis (table
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Allard C. van der Wal (2007) studied this question.
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