Angina due to coronary artery spasm (variant angina): diagnosis and intervention strategies

Nguyen, Thanh Ha; Ong, Gao-Jing; Girolamo, O.; Caceres, Viviane; Muminovic, Armin; Chirkov, Yuliy Y.; Horowitz, John D.

doi:10.1080/14779072.2021.1991314

Cited by 10 publications

(5 citation statements)

References 78 publications

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“…The results of the study show that the serum levels of Nitric oxide and Prostacyclin in Prinzmetal angina patients are significantly lower than in healthy individuals, and the patients’ , serum Thromboxane B 2 is significantly higher than in healthy persons. Nguyen et al indicated that the cause of spasms in these patients is the low production of Nitric oxide in the vascular endothelium [ 13 ]. Acetylcholine is released from parasympathetic nerves during rest [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prinzmetal angina (synonyms: vasospastic angina (VS), variant angina, spontaneous angina) is a rare type of angina pectoris caused by spasms of blood vessels supplying the heart and accompanied by an elevation of the ST segment in the electrocardiogram [ 12 ]. The clinical manifestation of spasms of the coronary arteries is the sudden onset of severe pain at rest or during sleep in the morning, less often in the daytime, with no obvious connection with physical stress, often developing at the same time of day [ 13 , 14 ]. The clinical features of this angina are unbearable pain, excessive sweating, tachycardia, and hypotension.…”

Section: Introductionmentioning

confidence: 99%

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Adherence to the Mediterranean Diet Association with Serum Levels of Nitric Oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal Angina Patients and Healthy Persons

Mohajeri

Cicero

2023

Nutrients

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This study aimed to assess the association between adherence to the Mediterranean diet with serum Nitric oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal angina patients and healthy persons. This case-control study was conducted among 100 Prinzmetal angina patients and 100 healthy persons referred to the Ardabil Imam Khomeini hospital between 2021 and 2022. Blood samples were obtained from all study participants for measurement of serum Nitric oxide, Prostacyclin, and Thromboxane B2. To calculate adherence to the Mediterranean diet, the ten-item screener was used. The serum Nitric oxide in patients who adhered more to the Mediterranean diet was higher than patients with less adherence (coeff. = 0.41 p = 0.04). The serum Prostacyclin level in patients with greater adherence to the Mediterranean diet was 0.34 units higher than patients with less adherence (coeff. = 0.34 p = 0.02). The level of serum Thromboxane B2 had a negative association with adherence to the Mediterranean diet (coeff. = −0.48 p = 0.04). The amount of consumption of olive oil, fruits, vegetables, and legumes in healthy people was more than Prinzmetal angina patients. In Prinzmetal angina patients, more adherence to the Mediterranean diet can decrease the serum Thromboxane B2 and increase the serum Nitric oxide and Prostacyclin.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adherence to the Mediterranean Diet Association with Serum Levels of Nitric Oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal Angina Patients and Healthy Persons

Mohajeri

Cicero

2023

Nutrients

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“… 39 History of associated symptoms such as migraine, Raynaud’s phenomenon and Kounis syndrome may increase suspicion of a diagnosis of VSA. 40 …”

Section: Diagnosismentioning

confidence: 99%

Vasospastic angina: a review on diagnostic approach and management

Jenkins,

Pompei,

Ganzorig

et al. 2024

Therapeutic Advances in Cardiovascular Disease

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Vasospastic angina (VSA) refers to chest pain experienced as a consequence of myocardial ischaemia caused by epicardial coronary spasm, a sudden narrowing of the vessels responsible for an inadequate supply of blood and oxygen. Coronary artery spasm is a heterogeneous phenomenon that can occur in patients with non-obstructive coronary arteries and obstructive coronary artery disease, with transient spasm causing chest pain and persistent spasm potentially leading to acute myocardial infarction (MI). VSA was originally described as Prinzmetal angina or variant angina, classically presenting at rest, unlike most cases of angina (though in some patients, vasospasm may be triggered by exertion, emotional, mental or physical stress), and associated with transient electrocardiographic changes (transient ST-segment elevation, depression and/or T-wave changes). Ischaemia with non-obstructive coronary arteries (INOCA) is not a benign condition, as patients are at elevated risk of cardiovascular events including acute coronary syndrome, hospitalization due to heart failure, stroke and repeat cardiovascular procedures. INOCA patients also experience impaired quality of life and associated increased healthcare costs. VSA, an endotype of INOCA, is associated with major adverse events, including sudden cardiac death, acute MI and syncope, necessitating the study of the most effective treatment options currently available. The present literature review aims to summarize current data relating to the diagnosis and management of VSA and provide details on the sequence that treatment should follow.

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“…This rehabilitation comprises multiple interventions, including assessment, exercise training, dietary modification, behavioral adjustments, and adherence strategies, collectively enhancing cardiac function and structure[ 5 ]. Evidence suggests that cardiac rehabilitation reduces overall and cardiovascular mortality post-myocardial infarction[ 6 ]. Nevertheless, conventional rehabilitation lacks specificity, particularly for elderly patients with multiple comorbidities and poor compliance, rendering it less effective[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation

Yan,

Yang,

Chen

et al. 2024

World J Clin Cases

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BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion, promoting blood flow restoration and alleviating symptoms such as myocardial ischemia. And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis. Nevertheless, conventional rehabilitation lacks specificity, particularly for elderly patients with multiple comorbidities and poor compliance, rendering it less effective. AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention. METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group, while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group. Differences in Seattle Angina Questionnaire scores, survival quality (SF-36) scores, cardiopulmonary exercise function assessment index, echocardiographic cardiac function index, and adverse cardiovascular events were compared between the two groups. RESULTS After intervention, the rehabilitation group observed greater VO2 Max, maximum metabolic equivalent, eft ventricular ejection fraction, left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter. And the rehabilitation group observed greater scores of physical activity limitation, stable angina pectoris, treatment satisfaction, and SF-36 score. The incidence of adverse cardiovascular events in the two groups, showed no significant difference. CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery, consequently enhancing both quality of life and cardiopulmonary exercise tolerance.

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Angina due to coronary artery spasm (variant angina): diagnosis and intervention strategies

Cited by 10 publications

References 78 publications

Adherence to the Mediterranean Diet Association with Serum Levels of Nitric Oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal Angina Patients and Healthy Persons

Adherence to the Mediterranean Diet Association with Serum Levels of Nitric Oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal Angina Patients and Healthy Persons

Vasospastic angina: a review on diagnostic approach and management

Effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation

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