Chest pain without obstructive coronary artery disease: a case series.

Autor:	Sidik NP; West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Agamemnon Street, Glasgow G81 4DY, UK.; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., McDermott M; West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Agamemnon Street, Glasgow G81 4DY, UK., McEntegart MB; West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Agamemnon Street, Glasgow G81 4DY, UK.; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., Berry C; West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Agamemnon Street, Glasgow G81 4DY, UK.; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Jazyk:	angličtina
Zdroj:	European heart journal. Case reports [Eur Heart J Case Rep] 2020 Apr 24; Vol. 4 (3), pp. 1-6. Date of Electronic Publication: 2020 Apr 24 (Print Publication: 2020).
DOI:	10.1093/ehjcr/ytaa060
Abstrakt:	Background: Ischaemic heart disease is a leading cause of mortality in women. Even in those without obstructive coronary artery disease (CAD), women with angina continue to have increased mortality. There are gender differences in prevalence of different pathophysiologies, including functional disorders such as microvascular and vasospastic angina. Case Summary: We describe four cases of angina in women with no obstructive CAD, in whom coronary function testing was performed. These four patients were diagnosed with disorders of coronary vasomotion, including vasospastic angina and different endotypes of microvascular angina. Discussion: This case series highlights the different mechanisms of ischaemia in the absence of obstructive CAD. Patients with angina and no obstructive CAD classified by computed tomography coronary angiography may have myocardial ischaemia due to microvascular angina, vasospastic angina, or both. Conventional investigations risk under-diagnosing, and as a consequence under-treating, patients with these conditions. Coronary function testing, in the form of diagnostic guidewire-based tests and adjunctive acetylcholine provocation, has proven to be critical in the accurate diagnoses and appropriate management of these patients. (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu