Ischemia with non-obstructive coronary artery disease (INOCA), a common cause of angina, can occur due to coronary vasospasm, microvascular dysfunction, endothelial dysfunction, atherosclerosis or a combination of these mechanisms. We describe a case of adenosine-associated paradoxical coronary vasospasm and Takotsubo-like apical ballooning in a postmenopausal woman with underlying mild coronary atherosclerosis and microvascular dysfunction.
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http://dx.doi.org/10.1016/j.ahjo.2022.100101 | DOI Listing |
Tex Heart Inst J
January 2025
Center for Women's Heart and Vascular Health, The Texas Heart Institute, Houston, Texas.
Myocardial bridging is a frequent anomaly of the heart in humans and other animals. A myocardial bridge is typically characterized by the systolic narrowing seen with traditional catheter angiography, but this abnormality is not by itself a sign of ischemia or the need for intervention. In particular, transient spontaneous angina must be corroborated by reproducible narrowing during acetylcholine testing; this narrowing occurs during resting conditions and is responsive to nitroglycerin administration.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta.
A 42-year-old man experienced recurrent coronary artery spasm (CAS) secondary to eosinophilic asthma despite being on multiple medications. He underwent a successful unilateral stellate ganglion block followed by bilateral thoracoscopic sympathectomy, with no subsequent recurrence of CAS. These invasive therapies offer a potential treatment option for refractory CAS.
View Article and Find Full Text PDFCurr Cardiol Rep
January 2025
Division of Cardiology, Louisiana State University Health Sciences Center - Shreveport (LSUHSC-S), 1501 Kings Hwy, Shreveport, LA, 71103, USA.
Purpose Of Review: What is the pathophysiology and clinical findings as well as management of patients presenting with INOCA/MINOCA (Ischemia/Myocardial Infarction with Non-Obstructive Coronary Arteries).
Recent Findings: INOCA/MINOCA has a complex pathophysiology. In this review article, we aim to summarize the complex pathophysiology and clinical diagnosis, and review the current management options.
Prog Cardiovasc Dis
January 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States. Electronic address:
Ischemic heart disease is the most common cardiovascular cause of death in women worldwide. Obstructive coronary atherosclerosis is the primary cause of myocardial infarction (MI), however, non-atherosclerotic mechanisms of MI, such as spontaneous coronary artery dissection, vasospasm, microvascular dysfunction, embolization, inflammation, coronary anomalies, infectious and infiltrative causes are increasingly being recognized. Emerging data suggest that women are two to five times more likely to have an MI in the absence of coronary atherosclerosis compared to men, but they continue to remain underdiagnosed and undertreated, partly due to underdiagnosis and limited understanding of these mechanisms.
View Article and Find Full Text PDFCardiovasc Interv Ther
January 2025
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama City, 330-8503, Japan.
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