[A 38 YEARS-OLD YOUNG MALE WITH CHEST PAIN AND ECG CHANGES].

Coronary vasospasm is a well-known condition causing acute chest syndrome and can lead to myocardial infarction, ventricular arrhythmias, and even sudden cardiac death. While there are extensive case series showing the association of coronary vasospasm with drugs like cocaine, the association of marijuana with coronary vasospasm has not been reported frequently. When smoked, marijuana results in a rapid, dose-dependent tachycardia, an increase in blood pressure, and an increase in cardiac output.

Pathological findings at invasive assessment in MINOCA: a systematic review and meta-analysis.

Background: Pathological mechanisms of myocardial infarction with non-obstructive coronary arteries (MINOCA) are heterogeneous, with an unknown impact on prognosis, and often remain unrecognised in clinical practice. This study aimed to evaluate the prevalence and prognostic impact of pathological findings by invasive coronary angiography (ICA), optical coherence tomography (OCT), and coronary function testing in MINOCA.

Methods: Studies published until August 2023 were searched on PubMed and SCOPUS and included if reporting the prevalence of patients with non-obstructive coronary arteries (NObs-CA; 1-49% coronary stenosis) versus normal coronary arteries (NCA; 0% coronary stenosis) by ICA, pathological findings by OCT, and/or coronary vasomotor tests in MINOCA.

Rare Clinical Manifestation of Vasculitis.

Background: Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis usually affects small blood vessels and is characterized by the presence of circulating autoantibodies (c-ANCA or p-ANCA). The risk of cardiovascular events is threefold higher compared to general population, and cardiac manifestations include myocarditis, pericarditis, valvulitis, aortitis, or coronary arteritis. Coronary involvement is very rare, but it is a potentially life-threatening manifestation.

A rare complication of blood donation: MINOCA.

Blood donation is a life-saving process that involves the temporary loss of a specific blood volume. Although generally safe, it may lead to adverse reactions, particularly in first-time donors. Among these, severe outcomes like myocardial infarction (MI) are extremely rare.

Intra-operative and post-operative management of conduits for coronary artery bypass grafting: a clinical consensus statement of the European Society of Cardiology Working Group on Cardiovascular Surgery and the European Association for Cardio-Thoracic Surgery Coronary Task Force.

The structural and functional integrity of conduits used for coronary artery bypass grafting is critical for graft patency. Disruption of endothelial integrity and endothelial dysfunction are incurred during conduit harvesting subsequent to mechanical or thermal injury and during conduit storage prior to grafting, leading to acute thrombosis and early graft failure. Late graft failure, in particular that of vein grafts, is precipitated by progressive atherogenesis.

Immunotherapy-mediated myocarditis and concurrent vasospastic angina in a patient with established ischaemic heart disease: a case report.

Background: Immunotherapy has become a pillar of modern oncological management but is associated with significant immunotherapy-related adverse events (IRAEs). While myocarditis is a prominent IRAE which clinicians are increasingly aware of, immunotherapy-related coronary vasospasm is far less appreciated and can be especially difficult to elucidate in pre-existing coronary artery disease. This case demonstrates the approach to diagnosis and management of multiple cardiovascular and non-cardiovascular IRAEs.

Coronary artery injury in pulsed field ablation.

Purpose Of Review: Although pulsed field ablation (PFA) has emerged as an innovative nonthermal catheter ablation modality, recent reports raise concerns about its potential impact on nearby coronary arteries. This review provides a comprehensive overview of the current understanding and future directions regarding the effects of PFA on or near coronary arteries.

Recent Findings: Clinical studies have demonstrated the risks of acute transient vasospasm after delivery of PFA, especially with ablation of structures in proximity to the coronary arteries, such as the cavotricuspid and mitral isthmuses.

Word of caution: clinically apparent coronary spasm following pulsed field cavotricuspid isthmus ablation despite nitroglycerin prophylaxis - a case report.

Background: Pulsed field ablation (PFA) is a novel ablation technology. A rare side-effect is the occurrence of mostly subclinical coronary spasms when PF energy is applied in proximity to coronary arteries. However, it has been described that prior application of nitroglycerin attenuates these effects.

Early recurrence of spontaneous coronary artery dissection: potential association with coronary vasospasm and optimal timing for spasm provocation test-a case series.

Background: Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS). Various factors predispose individuals to SCAD, including coronary vasospasm, which has been identified in some studies as a related factor.

Case Summary: We present a series of three cases of ACS attributed to SCAD.

The Clinical Approach to Angina in Women.

Women presenting with angina are more likely to have cardiac chest pain accompanied more frequently by associated symptoms like abdominal pain and lightheadedness. The evaluation of women with suspected coronary disease can be complex because many have microvascular dysfunction, coronary vasospasm, and altered coagulation that require specific testing protocols beyond the conventional stress testing and a coronary angiogram. Therefore, terms such as angina, ischemia, and myocardial infarction with no obstructive coronary disease have been introduced in recent years.

Refractory vasospastic angina in a patient with autoimmune hepatitis managed by using combined non-invasive provocation tests: A case report.

Unlabelled: Corticosteroids have emerged as a feasible treatment option for patients with refractory vasospastic angina (VSA) who have an allergic disease or hypereosinophilia. However, reports on VSA following the administration of corticosteroids are scarce. Herein, we present the rare case of a 49-year-old Japanese man who developed VSA while receiving corticosteroids for treatment of autoimmune hepatitis.

Vasospasm-Induced Myocardial Infarction and Syncope Manifesting as Recurrent Chest Pain.

We present a case of coronary vasospasm that presented as an acute ST-segment elevation myocardial infarction following a syncopal event, which was preceded by an episode of crushing chest pain. This report discusses proper diagnosis and treatment of cardiogenic syncope and recurrent chest pain secondary to uncontrolled coronary vasospasm.