Management of vasospastic angina

Beltrame JF Management of vasospastic angina Heart 2023;109:70-77.


Vasospastic angina is a well-established cause of chest pain that is caused by coronary artery spasm. It can be clinically diagnosed during a spontaneous episode by documenting nitrate-responsive rest angina with associated transient ischaemic ECG changes but more often requires provocative coronary spasm testing with acetylcholine during coronary angiography. Vasospastic angina may result in recurrent episodes of angina (including nocturnal angina), which can progress on to major adverse cardiac events. Calcium channel blockers are first-line therapy for this condition, given their anti-anginal and cardioprotective benefits. Despite an established diagnostic and therapeutic management pathway for vasospastic angina, this diagnosis is often overlooked in patients presenting with chest pain. Thus, there is need for increased clinical awareness of vasospastic angina to improve outcomes in affected patients.


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Authors: John F Beltrame

Publication: Heart

Publisher: BMJ Publishing Group Ltd.

Date published: January 1st, 2023


Copyright © 2023, BMJ Publishing Group Ltd. & British Cardiovascular Society

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