The Autonomic Nervous System in its Relation to Some Forms of Heart and Lung Disease: I. Heart Disease

Coronary Microvascular Spasm: Clinical Presentation and Diagnosis

“…[47][48][49][50][51][52][53][54][55][56][57] This proposal initially faced many criticisms because it contradicted the prevailing dogma that myocardial ischaemia was solely attributable to fixed obstructive coronary artery disease. 46,58,59 Indeed, coronary vasospasm was once defined as "the resort of the diagnostically destitute" based on the pathological notion that atherosclerotic coronary arteries could not constrict. 59 Nonetheless, an expanding body of evidence has demonstrated that coronary functional abnormalities manifested as coronary vasospasm and CMD play distinct roles in the pathophysiology of myocardial ischaemia across a wide spectrum of cardiovascular diseases.…”

“…46,58,59 Indeed, coronary vasospasm was once defined as "the resort of the diagnostically destitute" based on the pathological notion that atherosclerotic coronary arteries could not constrict. 59 Nonetheless, an expanding body of evidence has demonstrated that coronary functional abnormalities manifested as coronary vasospasm and CMD play distinct roles in the pathophysiology of myocardial ischaemia across a wide spectrum of cardiovascular diseases. 19,41,44,[60][61][62] In the 2019 European Society of Cardiology Guidelines for the diagnosis and management of chronic coronary syndromes (CCS), patients with angina and suspected vasospastic or microvascular disease are classified as CCS V, which is one of the most frequently encountered clinical scenarios in patients with CCS.…”