Key result
Patients with vasospastic angina share the common pathophysiological phenomenon of vascular smooth muscle hyperreactivity leading to spasm, which is often related to epicardial atherosclerosis.
Intracoronary imaging demonstrates that focal coronary spasm in vasospastic angina is closely related to underlying structural abnormalities, particularly non-calcified epicardial atherosclerosis and intimal thickening.
Intracoronary imaging may refine vasospastic angina evaluation; leaves open whether plaque-directed therapies improve outcomes.
Coronary spasm is involved in many clinical scenarios, such as stable angina, acute coronary syndrome, sudden cardiac death, non-ischemic cardiomyopathy, arrhythmia and syncope. In recent years, imaging tools such as computerized tomographic angiography, intravascular ultrasound or optical coherence tomography have been applied to study the coronary pathology in patients with vasospastic angina. Patients with vasospastic angina represent a heterogeneous cohort of patients with regard to the extent of concomitant coronary atherosclerosis. They share the common pathophysiological phenomenon of vascular smooth muscle hyperreactivity leading to spasm caused by various factors that may also overlap. Focal coronary spasm is related to epicardial atherosclerosis and in the presence of obstructive coronary artery disease it may be useful to treat the lesion to prevent further spasm. The aim of this article is to review structural and functional coronary artery abnormalities in patients with vasospastic angina.
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Aziz et al. (2015) conducted a review in Vasospastic Angina Pectoris. Patients with vasospastic angina share the common pathophysiological phenomenon of vascular smooth muscle hyperreactivity leading to spasm, which is often related to epicardial atherosclerosis.
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