Four patients with medically refractory unstable angina are presented. Each patient had ST-segment abnormalities during some episode of pain. Three patients had at least one episode of documented ST-segment elevation with their spontaneously occurring chest pain. One had recurrent ventricular tachycardia. Two patients had prior myocardial infarction. Angiography demonstrated localized left vent...

Myocardial infarction occurring in young people with angiographically normal coronary arteries is well described but the pathophysiology of this condition remains unknown. Coronary artery spasm in association with thrombus formation and minimal atheromatous disease or spontaneous coronary artery dissection are possible causes. Two young men presented with severe chest pain after acute alcohol i...

Variant angina, defined as spontaneous angina pectoris associated with transient ST-segment elevation, is usually caused by episodic coronary spasm. At present, coronary artery spasm is a reversible coronary stenosis that limits coronary blood flow under resting conditions. Prinzmetal first described this type of angina pectoris as a distinct entity in 1959. Although several hypotheses have bee...

BACKGROUND Coronary artery spasm plays an important role in the pathogenesis of vasospastic angina, and contributes to the development of several acute coronary syndromes. Endothelial nitric oxide synthase (ecNOS) catalyzes the synthesis of nitric oxide, which regulates vascular tone, and may be related to coronary vasospasm. The present study investigated whether coronary spasm is related to p...

A 60 year old man with a history of frequent episodes of chest pain and dizziness was referred for evaluation of coronary artery disease. He had no significant coronary artery stenosis at baseline coronary angiography. A carotid sinus massage was performed for evaluation of carotid sinus hypersensitivity in the patient. Both heart rate and blood pressure decreased a little, and returned to base...

We report a case of rapid resolution of Coronary Artery Spasm (CAS) and improvement of systolic heart failure by antirejection therapy with methylprednisolone in the setting of acute Orthotopic Heart Transplant (OHT) rejection. The proposed mechanism of action is reduced microvascular inflammation from steroid therapy resulting in enhanced vasomotor response, resolution of coronary artery spasm...

To evaluate whether the flow-mediated vasodilation and coronary flow reserve are impaired or not in patients with vasospastic angina (VA), we measured the changes of epicardial coronary artery diameter and flow reserve in spasm related-left anterior descending coronary artery (LAD). The flow mediated-response of epicardial coronary arteries in 15 VA were compared with 15 controls. Using quantit...