Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2018; 10(11): 201-209
Published online Nov 26, 2018. doi: 10.4330/wjc.v10.i11.201
Coronary spasm: It’s common, but it’s still unsolved
Hiroki Teragawa, Chikage Oshita, Tomohiro Ueda
Hiroki Teragawa, Chikage Oshita, Tomohiro Ueda, Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima 732-0057, Japan
Author contributions: All the authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflict of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Hiroki Teragawa, FACC, FACP, FAHA, MD, PhD, Chief Doctor, Department of Cardiovascular Medicine, JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima 732-0057, Japan. hiroteraga71@gmail.com
Telephone: +81-82-2621171 Fax: +81-82-2621499
Received: July 30, 2018
Peer-review started: July 30, 2018
First decision: August 20, 2018
Revised: September 21, 2018
Accepted: October 7, 2018
Article in press: October 7, 2018
Published online: November 26, 2018
Processing time: 119 Days and 12.2 Hours
Abstract

Coronary spasm is caused by a transient coronary narrowing due to the constriction of epicardial coronary artery, which leads to myocardial ischemia. More than 50 years have passed since the first recognition of coronary spasm, and many findings on coronary spasm have been reported. Coronary spasm has been considered as having pivotal roles in the cause of not only rest angina but also exertional angina, acute coronary syndrome, and heart failure. In addition, several new findings of the mechanism of coronary spasm have emerged recently. The diagnosis based mainly on coronary angiography and spasm provocation test and the mainstream treatment with a focus on a calcium-channel blocker have been established. At a glance, coronary spasm or vasospastic angina (VSA) has become a common disease. On the contrary, there are several uncertain or unsolved problems regarding coronary spasm, including the presence of medically refractory coronary spasm (intractable VSA), or an appropriate use of implantable cardioverter defibrillator in patients with cardiac arrest who have been confirmed as having coronary spasm. This editorial focused on coronary spasm, including recent topics and unsolved problems.

Keywords: Vasospastic angina; Medically refractory coronary spasm; Variant angina; Coronary vasospasm

Core tip: Coronary spasm is the transient vasoconstriction of epicardial coronary artery, leading to myocardial ischemia. Recently, coronary spasm has become widely accepted as one of the important pathophysiologies of coronary artery disease. However, even at present, there are several unsolved problems regarding coronary spasm.