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Management of vasospastic angina
  1. John F Beltrame1,2,3
  1. 1Discipline of Medicine, The University of Adelaide Adelaide Medical School, Adelaide, South Australia, Australia
  2. 2Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
  3. 3Basil Hetzel Institute, Adelaide, South Australia, Australia
  1. Correspondence to Professor John F Beltrame, Discipline of Medicine, The University of Adelaide Adelaide Medical School, Adelaide, South Australia, Australia; john.beltrame{at}adelaide.edu.au

Abstract

Vasospastic angina is a well-established cause of chest pain that is caused by coronary artery spasm. It can be clinically diagnosed during a spontaneous episode by documenting nitrate-responsive rest angina with associated transient ischaemic ECG changes but more often requires provocative coronary spasm testing with acetylcholine during coronary angiography. Vasospastic angina may result in recurrent episodes of angina (including nocturnal angina), which can progress on to major adverse cardiac events. Calcium channel blockers are first-line therapy for this condition, given their anti-anginal and cardioprotective benefits. Despite an established diagnostic and therapeutic management pathway for vasospastic angina, this diagnosis is often overlooked in patients presenting with chest pain. Thus, there is need for increased clinical awareness of vasospastic angina to improve outcomes in affected patients.

  • coronary angiography
  • angina pectoris
  • coronary vessels
  • chest pain
  • pharmacology, clinical

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Footnotes

  • Contributors The concept, design and writing was undertaken by the author.

  • Funding The research studies defining the nomenclature for vasospastic angina was supported by The Hospital Research Foundation Group.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Author note References which include a * are considered to be key references.