Approximately half of patients with coronary spastic angina had pathologic exercise tests

Sueda, Shozo; Miyoshi, Toru; Sasaki, Yasuhiro; Sakaue, Tomoki; Habara, Hirokazu; Kohno, Hiroaki

doi:10.1016/j.jjcc.2016.01.009

Cited by 5 publications

(4 citation statements)

References 26 publications

(24 reference statements)

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“…In patients with variant angina or CSA, 37.8% to 67.5% of patients had positive ischemic findings as shown in Table 1. Organic stenosis was found in 14.7% to 74.6% of these patients [15,[20][21][22]. Table 2a showed that more than a third patient with CSA and without organic stenosis had ischemic findings on exercise tests, while more than two thirds patients with CSA with organic stenosis had ischemic findings on exercise testing as shown in Table 2b.…”

Section: Treadmill Exercise Testsmentioning

confidence: 93%

“…Yasue et al reported that chest pain develops in approximately a third of episodes of ischemic ST change in patients with variant angina, and the remaining two thirds events of coronary artery spasm were asymptomatic. In our 300 patients with CSA, just four patients (1.3%) had transient ST elevation (Table 1) and 18 patients (6%) with CSA had abnormal findings during 24-hour Holter examinations [15]. Before performing coronary angiography, we should try to perform the Holter recordings to obtain the ischemic ECG changes possibly due to coronary artery spasm.…”

Section: Holter Ecgmentioning

confidence: 99%

“…The JCS guidelines defined the exercise test as class IIa when exercise test was performed in the early morning and daytime in patients with diurnal variation in exercise tolerance. In 300 patients with CSA, positive treadmill exercise tests were recognized in 113 patients (37.6%) and borderline was observed in 30 patients (10%) [15]. Therefore, approximately a half of the patients had pathologic response in treadmill exercise tests before coronary angiography.…”

Section: Treadmill Exercise Testsmentioning

confidence: 99%

See 2 more Smart Citations

Overview of the Non-Invasive Examinations in Patients with Coronary Spastic Angina

Sueda¹,

Kohno²

2017

J Cardiovasc Dis Diagn

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Exercise test, hyperventilation test or cold pressor test was employed to reproduce ST elevation in patients with variant angina. However, cardiologists could not get the high positive frequency from these tests in patients without high disease activity. Now a days, cardiologists can easily perform coronary angiography or coronary computed tomography. Cardiologists skipped the non-invasive spasm provocation tests such as hyperventilation test or cold pressor test to diagnose patients with coronary artery spasm. Approximately a half patient with coronary spasm had pathologic responses of exercise tests. More than a third patient with coronary spasm and without fixed stenosis had ischemic findings on exercise tests, whereas more than two-third patients with coronary spasm and with organic stenosis had pathologic responses on exercise testing. We should reconsider the usefulness of exercise tests to obtain the ischemic findings due to coronary artery spasm in the clinic before performing the cardiac catheterization.

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Section: Treadmill Exercise Testsmentioning

confidence: 93%

Section: Holter Ecgmentioning

confidence: 99%

Section: Treadmill Exercise Testsmentioning

confidence: 99%

See 1 more Smart Citation

Overview of the Non-Invasive Examinations in Patients with Coronary Spastic Angina

Sueda¹,

Kohno²

2017

J Cardiovasc Dis Diagn

Self Cite

View full text Add to dashboard Cite

show abstract

“…According to the guideline on coronary spasm[ 28 , 29 ], the recognition of transient changes in ST-T segments on electrocardiogram (ECG) during chest symptoms, as well as the presence of chest symptoms derived from coronary spasm, including the good responses to sublingual nitroglycerin and timing of occurrence of coronary spasm at rest, during sleep, or early in the morning, is very important in the diagnosis of VSA. Thus, needless to say, Holter ECG monitoring is important in the diagnosis of VSA[ 28 ]; however, Sueda et al[ 44 ] reported that approximately half of VSA patients had pathologic exercise tests, showing the importance of exercise ECG testing in the clinical setting. Exercise ECG testing may be also useful in patients suspected of coronary spasm (Table 1 ).…”

Section: Diagnosis Of Coronary Spasmmentioning

confidence: 99%

Coronary spasm: It’s common, but it’s still unsolved

Teragawa¹,

Oshita²,

Ueda³

2018

WJC

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Coronary spasm is caused by a transient coronary narrowing due to the constriction of epicardial coronary artery, which leads to myocardial ischemia. More than 50 years have passed since the first recognition of coronary spasm, and many findings on coronary spasm have been reported. Coronary spasm has been considered as having pivotal roles in the cause of not only rest angina but also exertional angina, acute coronary syndrome, and heart failure. In addition, several new findings of the mechanism of coronary spasm have emerged recently. The diagnosis based mainly on coronary angiography and spasm provocation test and the mainstream treatment with a focus on a calcium-channel blocker have been established. At a glance, coronary spasm or vasospastic angina (VSA) has become a common disease. On the contrary, there are several uncertain or unsolved problems regarding coronary spasm, including the presence of medically refractory coronary spasm (intractable VSA), or an appropriate use of implantable cardioverter defibrillator in patients with cardiac arrest who have been confirmed as having coronary spasm. This editorial focused on coronary spasm, including recent topics and unsolved problems.

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Treatment of Coronary Artery Spasm

Matsumoto

Nishimiya

Ohyama

et al. 2020

Coronary Vasomotion Abnormalities

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Approximately half of patients with coronary spastic angina had pathologic exercise tests

Abstract: TET was useful in documenting ischemia in patients with CSA. More than a third of patients with CSA had positive TETs. Moreover, we obtained the pathologic TET response in approximately half of patients with CSA.

Cited by 5 publications

References 26 publications

Overview of the Non-Invasive Examinations in Patients with Coronary Spastic Angina

Overview of the Non-Invasive Examinations in Patients with Coronary Spastic Angina

Coronary spasm: It’s common, but it’s still unsolved

Treatment of Coronary Artery Spasm

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