Menu
Introduction
The diagnostic and therapeutic approach for patients with chronic coronary syndromes (CCS) is evolving from a simplistic approach focused on diagnosis and treatment of obstructive epicardial coronary artery disease (CAD) to include a comprehensive assessment of the functional status of the coronary circulation to assess causes of angina with non-obstructive coronary arteries (ANOCA).
ANOCA is present […]
Cardiovascular disease is one of the leading causes of mortality in women, despite underrepresentation in the medical literature. Women have higher rates of ischemia and no obstructive coronary artery disease (INOCA) and myocardial infarction with no obstructive coronary artery disease (MINOCA) compared to men. The aim of this review is to describe the occupational, economic, and psychosocial factors which disproportionately impact women with (M)INOCA.
Ischemic heart disease (IHD) is common in women, and cardiovascular disease is a leading cause of morbidity and mortality. While obstructive coronary artery disease is the most common form of IHD, millions of women suffer from angina with nonobstructive coronary arteries (ANOCA), an umbrella term encompassing multiple nonatherosclerotic disorders of the coronary tree.
The underlying pathology leading to ischemia in these syndromes may be challenging to diagnose, leaving many women without a diagnosis despite persistent symptoms that impact quality of life and adversely affect long-term cardiovascular prognosis. In the last decade, there have been significant advances in the recognition and diagnostic evaluation of ANOCA.
Acetylcholine (ACh) provocation testing can detect vasomotor disorders in patients with ischemia and non-obstructed coronary arteries (INOCA) or myocardial infarction and non-obstructed coronary arteries (MINOCA). We aimed to derive and validate a simple risk score to predict a positive ACh test response.
We prospectively enrolled consecutive INOCA and MINOCA patients undergoing ACh provocation testing. Patients were split in two cohorts (derivation and validation) according to time of enrolment. The score was derived in 386 patients (derivation cohort) and then validated in 165 patients (validation cohort).
The syndrome of chest pain and/or myocardial ischemia with normal or nonobstructive coronary arteries at angiography is common and is of practical importance to the general medical audience. Many studies have tried to address this topic over the last 4 decades. Only 1 thing is clear: for patients with ongoing signs and symptoms of ischemia in acute coronary syndromes, the prognosis is not so favorable, as believed earlier in the 1990s. Yet, physicians remain confused by other patients who refer a history of effort angina or angina-like chest pain whose coronary angiograms show no evidence of obstructive coronary artery disease (CAD) and who have no structural heart disease.
Professor Maseri pioneered the research and treatment of coronary vasomotion abnormalities represented by coronary vasospasm and coronary microvascular dysfunction (CMD).
These mechanisms can cause myocardial ischaemia even in the absence of obstructive coronary artery disease, and have been appreciated as an important aetiology and therapeutic target with major clinical implications in patients with ischaemia with non-obstructive coronary artery disease (INOCA). Coronary microvascular spasm is one of the key mechanisms responsible for myocardial ischaemia in patients with INOCA.
International Heart Spasms Alliance (IHSA) is a global initiative lead by experts through experience. These are patients who are living with coronary vasospasms and microvascular angina, while also working in a collaborative equal partnership with clinicians.
We have invited healthcare professionals from around the world to our alliance to work with us in an equal partnership. These are expert cardiologists and healthcare professionals who are interested in learning more about and further researching these NOCAD conditions. Together, we are looking to spread worldwide awareness to help further research and bring faster diagnoses to patients suffering from these often-overlooked heart conditions.
Myocardial infarction in the absence of obstructive coronary artery disease is found in ≈5% to 6% of all patients with acute infarction who are referred for coronary angiography. There are a variety of causes that can result in this clinical condition.
As such, it is important that patients are appropriately diagnosed and an evaluation to uncover the correct cause is performed so that, when possible, specific therapies to treat the underlying cause can be prescribed.
First came the headaches – worse than migraines – then the shortness of breath and having to lay down after crossing the room.
Five months after my symptoms began, I was diagnosed with a 99% blockage in my LAD and 99% blockage in an artery branch off that.
I was stented and, in doing so, they jailed an artery. I was given Metoprolol and I got worse.
I underwent another Angiogram, and all was fine, so they changed my medication and I began to use my Nitro more.
I had my first heart attack in 2018. I was 67 years old.
After numerous trips to the hospital, tests, and frequent heart attack-like symptoms, I was diagnosed with Prinzmetal Angina and placed on medications.
I lost weight. I exercised. I was finally feeling better. I even got back to my painting.
Until…2019 happened.
My first episode caught me completely off guard on a Sunday morning in 2014. I was an active, healthy 35-year-old mother of 3. It felt like what I imagined having a heart attack would feel like. After a minute or two it stopped as suddenly as it had started and I got out of bed to start my day, I had experienced palpitations before and brushed it off as a once off.
I had about 8 more episodes before lunch time and made a deal with myself that if it continued, I would call an ambulance. I was a busy mum and didn’t want to be ‘dramatic’! It resolved by 2 p.m.
Learn all about the symptoms, causes and triggers of these heart conditions.
Input your search keywords and press Enter.
