Coronary vasospasm
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Coronary vasospasm Classification and external resources | |
| ICD-9 | 413.1 |
|---|---|
| DiseasesDB | 13727 |
| MedlinePlus | 000159 |
| eMedicine | med/447 |
| MeSH | D003329 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753
Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Synonyms and related key words: Coronary vasoconstriction, coronary artery spasm, vasospastic angina, variant angina, Prinzmetal angina, Prinzmetal's angina, focal coronary artery vasospasm, dynamic coronary obstruction
Coronary vasospasm is a form of vasospasm affecting the epicardial coronary artery of the coronary circulation.
A subtype of epicardial coronary artery spasm is known as Prinzmetal's angina. In this subtype of epicardial coronary artery vasospasm, symptoms typically occur at rest, rather than on exertion (thus attacks usually occur at night). Two-thirds of patients have concurrent atherosclerosis of a major coronary artery, but this is often mild or not in proportion to the degree of symptoms. Prinzmetal's angina is typically associated with specific EKG changes (elevation rather than depression of the ST segment).
(Cardiac) syndrome X is angina (chest pain) with signs associated with decreased blood flow to heart tissue but with normal coronary arteries. It is thought to involve the coronary microvasculature rather than the large epicardial arteries. It occurs more often in young women. Some studies have found increased risk of other vasospastic disorders in syndrome X patients, such as migraine and Raynaud's phenomenon. It is treated with calcium channel blockers, such as nifedipine, and usually carries a favorable prognosis. This is a distinct diagnosis from Prinzmetal's angina which involves spasm of the main epicardial coronary arteries. Syndrome X involves spasm of the downstream microvasculature.
Coronary vasospasm can occur in either a single epicardial coronary artery or in multiple epicardial coronary arteryies. [1][2] When it does occur in multiple vessels, the prognosis is worse as it may result in ventricular tachycardia or ventricular fibrillation. The patient with multivessel spasm may benefit from dual calcium channel blockade.
Calcium channel blockers and nitrates are the mainstay of chronic therapy for coronary vasospasm. Atropine has also been used to treat the condition.[3]
Differential Diagnosis of Coronary Vasospasm
(In alphabetical order)
- Acute pericarditis
- Angina pectoris
- Anxiety disorders
- Aortic dissection
- Cocaine toxicity
- Esophageal motility disorders
- Esophageal spasm
- Gastroesophageal reflux disease
- Isolated coronary artery anomalies
- Myocardial infarction
- Myocardial ischemia
- Panic disorder
- Unstable angina
Pathological Findings
 Coronary artery: Intramural Left Anterior Descending Artery: Micro, low mag, morphologically normal artery 72 years old female who developed anterior myocardial infarction after cholecystectomy |
 Coronary artery: Intramural Left Anterior Descending Artery: Micro, med mag, trichrome, abnormal media with fibrous tissue, 72 years old female who developed anterior myocardial infarction after cholecystectomy, There is no sign of atherosclerosis, but left anterior descending artery is intramural. |
References
- ↑ Ahooja V, Thatai D (July 2007). "Multivessel coronary vasospasm mimicking triple-vessel obstructive coronary artery disease". J Invasive Cardiol 19 (7): E178–81. PMID 17620681.
- ↑ Miwa K, Ishii K, Makita T, Okuda N (May 2004). "Diagnosis of multivessel coronary vasospasm by detecting postischemic regional left ventricular delayed relaxation on echocardiography using color kinesis". Circ. J. 68 (5): 483–7. PMID 15118293.
- ↑ Turkoglu S, Arpag U, Timurkaynak T (February 2007). "Spontaneous coronary vasospasm in the catheterisation laboratory: prompt resolution after atropine injection". Heart 93 (2): 215. doi:10.1136/hrt.2006.093187. PMID 17228071.
Further reading
- Hibino H, Kurachi Y (March 2006). "A new insight into the pathogenesis of coronary vasospasm". Circ. Res. 98 (5): 579–81. doi:10.1161/01.RES.0000215571.12500.ab. PMID 16543506.
WikiDoc Research Resources for Coronary vasospasm | |
|---|---|
| Articles on Coronary vasospasm | Most recent articles on Coronary vasospasm • Most cited articles on Coronary vasospasm • Review articles on Coronary vasospasm • Articles on Coronary vasospasm in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Coronary vasospasm | Powerpoint slides on Coronary vasospasm • Images of Coronary vasospasm • Photos of Coronary vasospasm • Podcasts & MP3s on Coronary vasospasm • Videos on Coronary vasospasm |
| Evidence Based Medicine Regarding Coronary vasospasm | Cochrane Collaboration on Coronary vasospasm • Bandolier on Coronary vasospasm • TRIP on Coronary vasospasm |
| Cost Effectiveness of Coronary vasospasm | Cost Effectiveness of Coronary vasospasm |
| Clinical Trials Involving Coronary vasospasm | Ongoing Trials on Coronary vasospasm at Clinical Trials.gov • Trial results on Coronary vasospasm • Clinical Trials on Coronary vasospasm at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Coronary vasospasm | US National Guidelines Clearinghouse on Coronary vasospasm • NICE Guidance on Coronary vasospasm • NHS PRODIGY Guidance • FDA on Coronary vasospasm • CDC on Coronary vasospasm |
| Textbook Information on Coronary vasospasm | Books and Textbook Information on Coronary vasospasm |
| Pharmacology Resources on Coronary vasospasm | Dosing of Coronary vasospasm • Drug interactions with Coronary vasospasm • Side effects of Coronary vasospasm • Allergic reactions to Coronary vasospasm • Overdose information on Coronary vasospasm • Carcinogenicity information on Coronary vasospasm • Coronary vasospasm in pregnancy • Pharmacokinetics of Coronary vasospasm • |
| Genetics, Pharmacogenomics, and Proteinomics of Coronary vasospasm | Genetics of Coronary vasospasm • Pharmacogenomics of Coronary vasospasm • Proteomics of Coronary vasospasm |
| Newstories on Coronary vasospasm | Coronary vasospasm in the news • Be alerted to news on Coronary vasospasm • News trends on Coronary vasospasm |
| Commentary on Coronary vasospasm | Blogs on Coronary vasospasm |
| Patient Resources on Coronary vasospasm | Patient resources on Coronary vasospasm • Discussion groups on Coronary vasospasm • Patient Handouts on Coronary vasospasm • Directions to Hospitals Treating Coronary vasospasm • Risk calculators and risk factors for Coronary vasospasm |
| Healthcare Provider Resources on Coronary vasospasm | Symptoms of Coronary vasospasm • Causes & Risk Factors for Coronary vasospasm • Diagnostic studies for Coronary vasospasm • Treatment of Coronary vasospasm |
| Continuing Medical Education (CME) Programs on Coronary vasospasm | CME Programs on Coronary vasospasm |
| International Resources on Coronary vasospasm | Coronary vasospasm en Espanol • Coronary vasospasm en Francais |
| Business Resources on Coronary vasospasm | Coronary vasospasm in the Marketplace • Patents on Coronary vasospasm |
| Informatics Resources on Coronary vasospasm | List of terms related to Coronary vasospasm |
| ||||
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
