Vasospastic angina: A literature review of current evidence.

Details

Serval ID
serval:BIB_E424ADE443B6
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Vasospastic angina: A literature review of current evidence.
Journal
Archives of cardiovascular diseases
Author(s)
Picard F., Sayah N., Spagnoli V., Adjedj J., Varenne O.
ISSN
1875-2128 (Electronic)
ISSN-L
1875-2128
Publication state
Published
Issued date
01/2019
Peer-reviewed
Oui
Volume
112
Number
1
Pages
44-55
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Vasospastic angina (VSA) is a variant form of angina pectoris, in which angina occurs at rest, with transient electrocardiogram modifications and preserved exercise capacity. VSA can be involved in many clinical scenarios, such as stable angina, sudden cardiac death, acute coronary syndrome, arrhythmia or syncope. Coronary vasospasm is a heterogeneous phenomenon that can occur in patients with or without coronary atherosclerosis, can be focal or diffuse, and can affect epicardial or microvasculature coronary arteries. This disease remains underdiagnosed, and provocative tests are rarely performed. VSA diagnosis involves three considerations: classical clinical manifestations of VSA; documentation of myocardial ischaemia during spontaneous episodes; and demonstration of coronary artery spasm. The gold standard diagnostic approach uses invasive coronary angiography to directly image coronary spasm using acetylcholine, ergonovine or methylergonovine as the provocative stimulus. Lifestyle changes, avoidance of vasospastic agents and pharmacotherapy, such as calcium channel blockers, nitrates, statins, aspirin, alpha1-adrenergic receptor antagonists, rho-kinase inhibitors or nicorandil, could be proposed to patients with VSA. This review discusses the pathophysiology, clinical spectrum and management of VSA for clinicians, as well as diagnostic criteria and the provocative tests available for use by interventional cardiologists.
Keywords
Angina Pectoris, Variant/diagnostic imaging, Angina Pectoris, Variant/epidemiology, Angina Pectoris, Variant/physiopathology, Angina Pectoris, Variant/therapy, Coronary Angiography, Coronary Vessels/diagnostic imaging, Coronary Vessels/drug effects, Coronary Vessels/physiopathology, Electrocardiography, Evidence-Based Medicine, Exercise Tolerance, Humans, Predictive Value of Tests, Prevalence, Prognosis, Risk Factors, Risk Reduction Behavior, Vasoconstriction, Vasodilator Agents/therapeutic use, Angor, Angor vasospastique, Prinzmetal, Variant angina, Vasospasm, Vasospasme, Vasospastic angina
Pubmed
Web of science
Create date
19/09/2018 10:21
Last modification date
20/08/2019 16:07
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