John F. Beltrame, Filippo Crea, Juan Carlos Kaski, Hisao Ogawa, Peter Ong, Udo Sechtem, Hiroaki Shimokawa, C. Noel Bairey Merz, on behalf of the Coronary Vasomotion Disorders International Study Group (COVADIS), 2016 Volume 80 Issue 2 Pages 289-298 https://doi.org/10.1253/circj.CJ-15-1202.
Ischemic heart disease involves both “structural” and/or “functional” disorders of the coronary circulation. Structural atherosclerotic coronary artery disease (CAD) is well recognized, with established diagnostic and treatment strategies. In contrast, “functional CAD” has received limited attention and is seldom actively pursued in the investigation of ischemic heart disease. Vasospastic angina encompasses “functional CAD” attributable to coronary artery spasm and this “state of the art” consensus statement reviews contemporary aspects of this disorder. Patients with vasospastic angina typically present with angina at rest that promptly responds to short-acting nitrates and is associated with transient ischemic ECG changes. Although spontaneous episodes may be documented, provocative spasm testing may be required to confirm the diagnosis. It is important to diagnose vasospastic angina because it may be associated with major adverse events that can be prevented with the use of appropriate vasodilator therapy (eg, calcium-channel blockers) and the avoidance of aggravating stimuli (eg, smoking). Future studies are required to clarify the underlying pathophysiology, natural history and effective treatments for patients refractory to conventional therapy. (Circ J 2016; 80: 289–298)
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Authors: John F. Beltrame, Filippo Crea, Juan Carlos Kaski, Hisao Ogawa, Peter Ong, Udo Sechtem, Hiroaki Shimokawa, C. Noel Bairey Merz, on behalf of the Coronary Vasomotion Disorders International Study Group (COVADIS)
Publication: Circulation Journal 2016 Volume 80 Issue 2
Publisher: The Japanese Circulation Society
Date published: Janury 25th, 2016
Copyright © 2016, The Japanese Circulation Society
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