How to Define Controlled Studies in Coronary Artery Spasm

Abstract

In 1959, Prinzmetal and Associates (1) defined the syndrome of “variant angina” and proposed that the mechanism of chest discomfort in this group of patients was due to coronary artery spasm associated with “fixed coronary artery occlusive disease”. Ensuing developments, including coronary angiography, long-term ECT recording, hemodynamic monitoring, myocardial radioisotope perfusion imaging and measurements of regional metabolism and coronary blood flow in man have substantiated the relationship between coronary artery spasm and the variant angina syndrome (2–11). Patient studies using these techniques have also implicated coronary artery spasm in the pathophysiology of many other ischemic syndromes besides variant angina pectoris (2,7,12-15). In addition, the provocation of coronary artery spasm by hyperventilation, by the intravenous administration of drugs by cold pressor testing has implicated a possible role of coronary spasm in ischemic heart disease in general (2, 16-22).KeywordsMyocardial IschemiaCold Pressor TestRadionuclide AngiographyChest DiscomfortCoronary SpasmThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.