Chronic stable angina clinical subset- vasospastic angina: Difference between revisions
New page: {{Chronic stable angina}} {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} '''''Synonyms and related keywords:''''' vasospastic angina, variant angina, prinzmetal's angina ==Overview== ... |
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'''2.''' [[Chronic stable angina ambulatory ST segment monitoring|Ambulatory ST Segment Monitoring]] to identify ST-deviation. ''(Level of Evidence: C)''}} | '''2.''' [[Chronic stable angina ambulatory ST segment monitoring|Ambulatory ST Segment Monitoring]] to identify ST-deviation. ''(Level of Evidence: C)''}} | ||
==ESC Guidelines for pharmacological therapy of vasospastic angina (DO NOT EDIT)<ref name="pmid16735367">{{cite journal| author=Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al.| title=Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. | journal=Eur Heart J | year= 2006 | volume= 27 | issue= 11 | pages= 1341-81 | pmid=16735367 | doi=10.1093/eurheartj/ehl001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16735367 }} </ref>== | |||
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===Class I=== | |||
'''1.''' Treatment with [[calcium channel blocker]] and if necessary [[nitrates]] in patients whose coronary arteriogram is normal or shows only non-obstructive lesions. ''(Level of Evidence: B)''}} | |||
==Sources== | ==Sources== | ||
Revision as of 15:53, 20 July 2011
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Chronic stable angina Microchapters | ||
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Classification | ||
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Differentiating Chronic Stable Angina from Acute Coronary Syndromes | ||
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Diagnosis | ||
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Alternative Therapies for Refractory Angina | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Synonyms and related keywords: vasospastic angina, variant angina, prinzmetal's angina
Overview
- Coronary artery spasm due hyperreactivity of the involved smooth muscle cells is considered to be the underlying mechanism responsible for variant angina.
- A significant group of patients with variant angina have obstructive coronary artery disease.[1]
- Precipitating factors for vasospasm are:
- cold stimulation
- smoking,
- cocaine use,
- electrolyte disturbances (potassium, magnesium),
- autoimmune diseases,
- hyperventilation,
- insulin resistance
- higher prevalence in Japanese populations.
- ST elevation is classically observed on ECG during an episode of vasospasm.
- Intracoronary acetylcholine or ergonovine provocation test is used to diagnose vasospasm.
- The prognosis of vasospastic angina depends on the extent of underlying CAD.
ESC Guidelines for diagnostic tests in suspected vasospastic angina (DO NOT EDIT)[2]
| “ |
Class I1. ECG during angina if possible. (Level of Evidence: B) 2. Coronary arteriography in patients with characteristic episodic chest pain and ST-segment changes that resolve with nitrates and/or calcium channel blockers to determine the extent of underlying coronary disease. (Level of Evidence: B) Class IIa1. Intracoronary provocative testing to identify coronary spasm in patients with normal findings or nonobstructive lesions on coronary arteriography and the clinical picture of coronary spasm. (Level of Evidence: B) 2. Ambulatory ST Segment Monitoring to identify ST-deviation. (Level of Evidence: C) |
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ESC Guidelines for pharmacological therapy of vasospastic angina (DO NOT EDIT)[2]
| “ |
Class I1. Treatment with calcium channel blocker and if necessary nitrates in patients whose coronary arteriogram is normal or shows only non-obstructive lesions. (Level of Evidence: B) |
” |
Sources
- Guidelines on the management of stable angina pectoris: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology [2]
References
- ↑ Maseri A, Severi S, Nes MD, L'Abbate A, Chierchia S, Marzilli M et al. (1978) "Variant" angina: one aspect of a continuous spectrum of vasospastic myocardial ischemia. Pathogenetic mechanisms, estimated incidence and clinical and coronary arteriographic findings in 138 patients. Am J Cardiol 42 (6):1019-35. PMID: 727129
- ↑ 2.0 2.1 2.2 Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F; et al. (2006). "Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology". Eur Heart J. 27 (11): 1341–81. doi:10.1093/eurheartj/ehl001. PMID 16735367.