After thickening of the cardiac chamber walls during embryogenesis, oxygen and nutrients can no longer be adequately supplied to cardiac cells via passive diffusion; therefore, a primitive vascular network develops to supply these vital structures. This plexus further matures into coronary arteries and veins, which ensures continued development of the heart. Various models have been proposed to account for the growth of the coronary arteries. However, lineage-tracing studies in the last decade have identified 3 major sources, namely, the proepicardium, the sinus venosus, and endocardium. Although the exact contribution of each source remains unknown, the emerging model depicts alternative pathways and progenitor cells, which ensure successful coronary angiogenesis. We aim to explore the current trends in coronary artery development, the cellular and molecular signals regulating heart vascularization, and its implications for heart disease and vascular regeneration.

Prinzmetal variant angina is characterized by episodic chest pain associated with transient ST changes seen on an electrocardiogram (EKG). A 51-year-old female with a pertinent history of non-obstructive coronary artery disease (CAD), non-ST elevation myocardial infarction (NSTEMI) twice, ST-elevation myocardial infarction (STEMI), Prinzmetal angina, ventricular tachycardia s/p implantable cardioverter-defibrillator placement, and gastroesophageal reflux disease presented with 2.5 hours of left-sided chest pain with radiation to the left arm. Her initial EKG was not revealing. However, a subsequent EKG showed ST elevations in the inferior leads. A coronary angiogram was performed and revealed distal right coronary artery spasm that was relieved with intracoronary nitroglycerin. The nature of her chest pain in conjunction with her EKG and angiogram findings helped diagnose her with Prinzmetal angina that was significant enough to result in a STEMI. Thus, Prinzmetal angina and STEMI can be interconnected rather than being separate, mutually exclusive pathologies.

No abstract

No abstract

No abstract