Acute Coronary Syndrome: Coronary Vasospasm, Emergency Medicine

Spontaneous episodes of chest pain due to coronary artery vasospasm in the absence of increase in myocardial oxygen demand in either normal or diseased coronary vessels

Also known as ...

Chest pain:

• Retrosternal

• Radiates to neck, jaw, left shoulder, or arm

• Occurs at rest

• Occurs more frequently at night or in the morning

Palpitations

Presyncope or syncope

Associate...

IV access

Oxygen

Cardiac monitoring

Vital signs and oxygen saturation

All patients wit...

New-onset chest pain

Rule-in with positive biochemical markers or provocative testing

Rule-in with positive biochemical markers or stress testing

Many patients prev...

95% survival at 5 yr

Typical patient will have no traditional coronary risk factors other than smoking.

Calcium-channel blockers are 1st-line therapy.

30–40% of patients are refractor...

Crea  F, Lanza  GA. New light on a forgotten disease: vasospastic angina. J Am Coll Cardiol.  2011;58(12):1238–1240.

Krim  NR, Narasimhan  S, Monrad  ES. Severe multivessel coro...

411.1 Intermediate coronary syndrome

413.1 Prinzmetal angina

I20.1 Angina pectoris with documented spasm

I24.9 Acute ischemic heart disease, unspecified

87343002 Prinzmetal angina (di...