Coronary artery spasm: Current knowledge and residual uncertainties

Slavich, Massimo; Patel, Riyaz

doi:10.1016/j.ijcha.2016.01.003

Cited by 59 publications

(56 citation statements)

References 89 publications

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“…Clinically, the combination of severe CAD and spasm is associated with adverse prognosis [31]. At autopsy, there are no distinctive gross or histologic hallmarks of CAS; thus, the possible morphologic substrates associated with an increased risk of spasm must be searched for, as well as microscopic evidence of ischemia.…”

Section: Coronary Spasmmentioning

confidence: 99%

Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification

et al. 2019

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Ischemic heart disease is one of the leading causes of morbidity and death worldwide. Consequently, myocardial infarctions are often encountered in clinical and forensic autopsies, and diagnosis can be challenging, especially in the absence of an acute coronary occlusion. Precise histopathological identification and timing of myocardial infarction in humans often remains uncertain while it can be of crucial importance, especially in a forensic setting when third person involvement or medical responsibilities are in question. A proper post-mortem diagnosis requires not only up-to-date knowledge of the ischemic coronary and myocardial pathology, but also a correct interpretation of such findings in relation to the clinical scenario of the deceased. For these reasons, it is important for pathologists to be familiar with the different clinically defined types of myocardial infarction and to discriminate myocardial infarction from other forms of myocardial injury. This article reviews present knowledge and postmortem diagnostic methods, including post-mortem imaging, to reveal the different types of myocardial injury and the clinicalpathological correlations with currently defined types of myocardial infarction.

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Section: Coronary Spasmmentioning

confidence: 99%

Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification

et al. 2019

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“…The diagnostic criteria for VSA, as proposed by the Coronary Vasomotor Disorders International Study Group (COVADIS) [7], includes nitrate sensitive angina with one of the following: rest angina; marked diurnal variation in exercise tolerance; hyperventilation-induced episode or calcium channel blocker-sensitive angina 7; transient ischemic ECG changes, including 0.1 mV ST elevation or depression or new negative U waves in at least two contiguous leads (7); and total or subtotal coronary artery spasm with angina and ischemic ECG changes, either spontaneously or in response to a provocative stimulus (7). Prinzmetal's angina differs from traditional stable angina pectoris anatomically, as it is not driven by atherosclerotic lumen encroachment within the coronary vasculature [8].…”

Section: Discussionmentioning

confidence: 99%

Severe Prinzmetal’s Angina Inducing Ventricular Fibrillation Cardiac Arrest

Khiatah

Philips

Dukes

et al. 2020

Case Reports in Cardiology

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Prinzmetal’s angina is a vascular spasm of the coronary artery that can mimic acute coronary syndrome. It is rarely responsible for ventricular arrhythmias and cardiac arrest; however, survivors with these complications are at increased risk for recurrent ventricular arrhythmias and sudden cardiac death. This is true despite the presence of normal cardiac function and optimal medical therapy. Thus, this select population should be considered for an implantable cardioverter defibrillator (ICD). In this case vignette, we describe a healthy 48-year-old female with ventricular fibrillation arrest, followed by recurrent ventricular tachyarrhythmias caused by Prinzmetal’s angina.

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“…Enhanced platelet aggregation, increased factor VII levels and increased carboxyhaemoglobin content causing decreased oxygen carrying capacity have all been reported and could potentially contribute to ischaemia 11 12. Additionally, cannabis can induce CAS, especially in the presence of underlying atherosclerotic plaques 13 14. Marijuana use is associated with increased chances of plaque rupture in high-risk lesions 8.…”

Section: Discussionmentioning

confidence: 99%

Marijuana-associated ST-elevation myocardial infarction: is this a benign drug

Kumar¹,

Srinivasamurthy

Karasik

et al. 2018

BMJ Case Rep

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Marijuana is the most commonly used psychoactive drug in the USA. A 35-year-old man with a medical history of marijuana abuse is admitted to the hospital due to crushing substernal chest pain. ECG shows evolving ST-segment elevation with a rise in cardiac enzymes, consistent with ST-elevation myocardial infarction. A urine toxicology screen is positive for cannabis and negative for cocaine and other stimulant drugs. An emergent cardiac catheterisation reveals no evidence of coronary artery disease or thrombosis. A diagnosis of coronary vasospasm is strongly considered, and the patient is started on calcium channel blocker, with a resolution of symptoms and ECG changes. Marijuana-induced coronary spasm causing myocardial infarction has rarely been reported. Marijuana is becoming a social norm in adolescents and there remains a misconception that it is harmless and even beneficial. Increasing drug abuse remains a public health concern, necessitating population education by physicians for safer healthcare practices.

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Coronary artery spasm: Current knowledge and residual uncertainties

Cited by 59 publications

References 89 publications

Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification

Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification

Severe Prinzmetal’s Angina Inducing Ventricular Fibrillation Cardiac Arrest

Marijuana-associated ST-elevation myocardial infarction: is this a benign drug

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