Atherosclerosis Atheroma is the main cause of obstruction of coronary arteries and accounts for more than 90% of cases of angina and coronary artery disease.
Coronary artery spasm (variant angina) — This is a rare cause of angina in which spasm of the coronary artery occurs often without identifiable stimuli. This condition, also called Prinzmetal’s variant angina, is more common in the Mediterranean and Italian popu¬lation. In some patients, exposure to cold, smoking, emotional stress, aspirin ingestion, or cocaine use may trigger coronary spasm. The coronary spasm is usually relieved by nitroglycerin, nitrates, and calcium antagonists, and discontinuation of these medications may cause worsening of spasm. Beta-blocking drugs may increase coronary artery spasm. The clinical hallmarks of coronary artery spasm include pain usually occurring at rest, often during sleep and described as chronic angina at rest, an ECG during pain showing elevation of the ST segment which is normalized by the use of nitroglycerin. The ST segment returns to normal on cessation of pain caused by coronary spasm.
Anomalous coronary artery — This rare occurrence may go undetected, see the chapter Congenital Heart Disease.

Страницы: 1 | 2 | 3