Myocardial Ischemic Syndromes, Heart Failure Syndromes, Electrocardiographic Abnormalities, Arrhythmic Syndromes and Angiographic Diagnosis of Coronary Artery Spasm: Literature Review

Abstract

In coronary artery spasm (CAS), an excess coronary vasoconstriction causing total or subtotal vessel occlusion could lead to syncope, heart failure syndromes, arrhythmic syndromes, and myocardial ischemic syndromes including asymptomatic myocardial ischemia, stable and unstable angina, acute myocardial infarction, and sudden cardiac death. Although the clinical significance of CAS has been underrated because of the frequent absence of symptoms, affected patients appear to be at higher risk of syncope, serious arrhythmias, and sudden death than those with classic Heberden's angina pectoris. Therefore, a prompt diagnosis has important therapeutic implications, and is needed to avoid CAS-related complications. While a definitive diagnosis is based mainly on coronary angiography and provocative testing, clinical features may help guide decision-making. We perform a literature review to assess the past and current state of knowledge regarding the clinical features, electrocardiographic abnormalities and angiographic diagnosis of CAS, while a discussion of mechanisms is beyond the scope of this review.

Segmentation and Classification of Heart Angiographic Images Using Machine Learning Techniques

“…However, the image processing context is discussed mainly with deep learning, and we present that the effect is more severe than this. Nonetheless, the procedure in which the outcomes brought to doctors are nontrivial, and we have also discussed our experience with this algorithm's deployment [ 11 ].…”

Association between Coronary Artery Spasm and the risk of incident Diabetes: A Nationwide population-based Cohort Study

“…Coronary artery spasm (CAS), an inflammatory nonobstructive coronary disease characterized by elevated C-reactive protein (CRP) levels, plays an important role in myocardial ischemia, infarction, and sudden death 1 , 2 . The 2 important risk factors for CAS 1 . smoking and CRP, are strongly correlated with insulin resistance 3 .…”

Coronary Artery Spasm is Associated With an Increased Risk of Incident Diabetes: A Nationwide Population-Based Cohort Study

“…Coronary artery spasm (CAS), an in ammatory nonobstructive coronary disease characterized by elevated C-reactive protein (CRP) levels, is important because it can result in myocardial ischemia, infarction, and sudden death [1,2]. The 2 important risk factors for CAS [1], smoking and CRP, are strongly correlated with insulin resistance [3,4]. Among non-diabetic patients, a signi cant positive association has been demonstrated between CAS and insulin resistance [5], leading to blood ow-dependent decrease in glucose disposal and hyperglycemia [6].…”

“…Although in ammation contributes to synergistic coupling of endothelial dysfunction and insulin resistance [6], treatment with insulin sensitizers to decrease vascular disease has yielded mixed results, perhaps because insulin resistance may promote not only obstructive atherosclerosis [7], but also CAS. On the other hand, racial heterogeneity exists in CAS [1] and insulin resistance [8], the prevalence of type 2 diabetes (diabetes) is not substantially different between Japanese [9] and Whites [10]. Hence, CAS is potentially important in modulating the development of diabetes in Asians.…”

“…Coronary artery spasm (CAS), an in ammatory nonobstructive coronary disease characterized by elevated C-reactive protein (CRP) levels, is important because it can result in myocardial ischemia, infarction, and sudden death [1,2]. The 2 important risk factors for CAS [1], smoking and CRP, are strongly correlated with insulin resistance [3,4].…”