Invasive Diagnosis of Coronary Functional Disorders Causing Angina Pectoris
Coronary vasomotion disorders represent a frequent cause of angina and/or dyspnoea in patients with non-obstructed coronary arteries. The highly sophisticated interplay of vasodilatation and vasoconstriction can be assessed in an interventional diagnostic procedure. Established parameters characteri...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Radcliffe Medical Media
2021-07-01
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| Series: | European Cardiology Review |
| Online Access: | https://www.ecrjournal.com/articleindex/ecr.2021.06 |
| _version_ | 1797200032263307264 |
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| author | Sascha Beck Valeria Martínez Pereyra Andreas Seitz Johanna McChord Astrid Hubert Raffi Bekeredjian Udo Sechtem Peter Ong |
| author_facet | Sascha Beck Valeria Martínez Pereyra Andreas Seitz Johanna McChord Astrid Hubert Raffi Bekeredjian Udo Sechtem Peter Ong |
| author_sort | Sascha Beck |
| collection | DOAJ |
| description | Coronary vasomotion disorders represent a frequent cause of angina and/or dyspnoea in patients with non-obstructed coronary arteries. The highly sophisticated interplay of vasodilatation and vasoconstriction can be assessed in an interventional diagnostic procedure. Established parameters characterising adequate vasodilatation are coronary blood flow at rest, and, after drug-induced vasodilation, coronary flow reserve, and microvascular resistance (hyperaemic microvascular resistance, index of microcirculatory resistance). An increased vasoconstrictive potential is diagnosed by provocation testing with acetylcholine or ergonovine. This enables a diagnosis of coronary epicardial and/or microvascular spasm. Ischaemia associated with microvascular spasm can be confirmed by ischaemic ECG changes and the measurement of lactate concentrations in the coronary sinus. Although interventional diagnostic procedures are helpful for determining the mechanism of the angina, which may be the key to successful medical treatment, they are still neither widely accepted nor applied in many medical centres. This article summarises currently well-established invasive methods for the diagnosis of coronary functional disorders causing angina pectoris. |
| first_indexed | 2024-03-07T17:40:39Z |
| format | Article |
| id | doaj.art-2b2a8494b8ab4f19aa1c80a2079474dd |
| institution | Directory Open Access Journal |
| issn | 1758-3756 1758-3764 |
| language | English |
| last_indexed | 2024-04-24T07:25:12Z |
| publishDate | 2021-07-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | European Cardiology Review |
| spelling | doaj.art-2b2a8494b8ab4f19aa1c80a2079474dd2024-04-20T16:02:16ZengRadcliffe Medical MediaEuropean Cardiology Review1758-37561758-37642021-07-011610.15420/ecr.2021.06Invasive Diagnosis of Coronary Functional Disorders Causing Angina PectorisSascha Beck0Valeria Martínez Pereyra1Andreas Seitz2Johanna McChord3Astrid Hubert4Raffi Bekeredjian5Udo Sechtem6Peter Ong7Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, GermanyDepartment of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, GermanyDepartment of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, GermanyDepartment of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, GermanyDepartment of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, GermanyDepartment of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, GermanyDepartment of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, GermanyDepartment of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, GermanyCoronary vasomotion disorders represent a frequent cause of angina and/or dyspnoea in patients with non-obstructed coronary arteries. The highly sophisticated interplay of vasodilatation and vasoconstriction can be assessed in an interventional diagnostic procedure. Established parameters characterising adequate vasodilatation are coronary blood flow at rest, and, after drug-induced vasodilation, coronary flow reserve, and microvascular resistance (hyperaemic microvascular resistance, index of microcirculatory resistance). An increased vasoconstrictive potential is diagnosed by provocation testing with acetylcholine or ergonovine. This enables a diagnosis of coronary epicardial and/or microvascular spasm. Ischaemia associated with microvascular spasm can be confirmed by ischaemic ECG changes and the measurement of lactate concentrations in the coronary sinus. Although interventional diagnostic procedures are helpful for determining the mechanism of the angina, which may be the key to successful medical treatment, they are still neither widely accepted nor applied in many medical centres. This article summarises currently well-established invasive methods for the diagnosis of coronary functional disorders causing angina pectoris.https://www.ecrjournal.com/articleindex/ecr.2021.06 |
| spellingShingle | Sascha Beck Valeria Martínez Pereyra Andreas Seitz Johanna McChord Astrid Hubert Raffi Bekeredjian Udo Sechtem Peter Ong Invasive Diagnosis of Coronary Functional Disorders Causing Angina Pectoris European Cardiology Review |
| title | Invasive Diagnosis of Coronary Functional Disorders Causing Angina Pectoris |
| title_full | Invasive Diagnosis of Coronary Functional Disorders Causing Angina Pectoris |
| title_fullStr | Invasive Diagnosis of Coronary Functional Disorders Causing Angina Pectoris |
| title_full_unstemmed | Invasive Diagnosis of Coronary Functional Disorders Causing Angina Pectoris |
| title_short | Invasive Diagnosis of Coronary Functional Disorders Causing Angina Pectoris |
| title_sort | invasive diagnosis of coronary functional disorders causing angina pectoris |
| url | https://www.ecrjournal.com/articleindex/ecr.2021.06 |
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