Heart, Lung and Circulation
Volume 16, Issue 1 , Pages 10-15, February 2007

The Mystery of Coronary Artery Spasm

  • Andrew E. Ajani, MD, FRACP, FJFICM, FCSANZ

      Affiliations

    • Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
    • National Health Medical Research Council, Centre of Clinical Research Excellence in Therapeutics Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
    • Corresponding Author InformationCorresponding author at: Department of Cardiology, Royal Melbourne Hospital, Grattan Street, Parkville 3050, Australia. Tel.: +61 3 9347 0499; fax: +61 3 9347 6760.
    • ,
  • Bryan P. Yan, FRACP

      Affiliations

    • Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia

Coronary artery spasm is an important cause of chest pain and myocardial ischaemia. It can be defined as an exaggerated contractile response of epicardial coronary artery smooth muscle to various stimuli but the underlying mechanism is not well understood. Recent studies have shown that the loss of endothelial vasodilatory function in conjunction with an increase in vascular smooth muscle constrictor sensitivity to calcium are the likely predisposing conditions for coronary spasm. This review highlights current understanding of the pathophysiology, predisposing factors, diagnostic and therapeutic approaches for coronary spasm.

Keywords: Coronary spasm, Endothelial dysfunction, Oxidative stress, Vascular smooth muscle

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PII: S1443-9506(06)00279-4

doi:10.1016/j.hlc.2006.11.003

Heart, Lung and Circulation
Volume 16, Issue 1 , Pages 10-15, February 2007

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