Angina due to coronary artery spasm (variant angina): diagnosis and intervention strategies.

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dc.contributor.authorNguyen, T.H.
dc.contributor.authorOng, G.-J.
dc.contributor.authorGirolamo, O.C.
dc.contributor.authordeMenezesCaceres, V.
dc.contributor.authorMuminovic, A.
dc.contributor.authorChirkov, Y.Y.
dc.contributor.authorHorowitz, J.D.
dc.date.issued2021
dc.description.abstractIntroduction: Since Prinzmetal first described a ‘variant’ form of angina pectoris, with predominantly resting episodes of pain and cyclic severity variations, it has gradually become apparent that this clinical presentation is caused by episodes of coronary artery spasm (CAS) involving focal or diffuse changes in large and/or small coronary arteries in the presence or absence of ‘fixed’ coronary artery stenoses. However, most clinicians have only limited understanding of this group of disorders. Areas covered: We examine the clinical presentation of CAS, associated pathologies outside the coronary vasculature, impediments to making the diagnosis, provocative diagnostic tests, available and emerging treatments, and the current understanding of pathogenesis. Expert opinion: CAS is often debilitating and substantially under-diagnosed and occur mainly in women. Many patients presenting with CAS crises have non-diagnostic ECGs and normal serum troponin concentrations, but CAS can be suspected on the basis of history and association with migraine, Raynaud’s phenomenon and Kounis syndrome. Definitive diagnosis requires provocative testing at coronary angiography. Treatment still centers around the use of calcium antagonists, but with greater understanding of pathogenesis, new management options are emerging.
dc.description.statementofresponsibilityThanh Ha Nguyen, Gao-Jing Ong, Olivia C Girolamo, Viviane De Menezes Caceres, Armin Muminovic, Yuliy Y Chirkov, John D Horowitz
dc.identifier.citationExpert Review of Cardiovascular Therapy, 2021; 19(10):917-9227
dc.identifier.doi10.1080/14779072.2021.1991314
dc.identifier.issn1477-9072
dc.identifier.issn1744-8344
dc.identifier.orcidNguyen, T.H. [0000-0002-8244-8655]
dc.identifier.orcidHorowitz, J.D. [0000-0001-6883-0703]
dc.identifier.urihttps://hdl.handle.net/2440/145867
dc.language.isoen
dc.publisherTaylor and Francis Group
dc.rights© 2021 Informa UK Limited, trading as Taylor & Francis Group
dc.source.urihttps://doi.org/10.1080/14779072.2021.1991314
dc.subjectVariant angina; coronary artery spasm; coronary slow flow phenomenon; acetylcholine test; pathogenesis; diagnosis; treatment
dc.subject.meshCoronary Vessels
dc.subject.meshHumans
dc.subject.meshSpasm
dc.subject.meshAngina Pectoris
dc.subject.meshAngina Pectoris, Variant
dc.subject.meshCoronary Vasospasm
dc.subject.meshCoronary Angiography
dc.subject.meshFemale
dc.titleAngina due to coronary artery spasm (variant angina): diagnosis and intervention strategies.
dc.typeJournal article
pubs.publication-statusPublished

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