Test the Vasospastic ST-Segment Depression Reversibility with Nitrates in Non-Obstructive Coronary Disease

Coronary artery spasm is an important common clinical cardiovascular disorder. It is defined as a transient constriction of the muscles in the wall of one or more of the coronary arteries. Myocardial injury and sudden cardiac death are possible remarkable sequels. Despite coronary spasm is a brief and temporary but can be permanent. In other words, it may be associated with or without significant coronary artery disease. However, Coronary spasm is hyperresponsive to the vasodilator effect of nitrates. Patients with different forms of coronary artery disease may respond differently. The quick reversibility response of ST-segment depression after using short-acting nitrates had achieved in my 3-case series. ST-segment depression reversibility with nitrates means that the ST-segment depressions for all cases were transient coronary vasospasm. However, coronary angiography was normal in all 3-cases. This is the principal of our test. Worthwhile, the objective of the test in the current article is to distinguish between the real coronary artery spasm with obstructive coronary artery disease from those with nonobstruction. The emergency differentiation for the cases of coronary artery spasm using nitrates via categorical stratification into obstructive and nonobstructive coronary artery disease is a pivotal step in future management.