Vasospastic angina

Pathogenesis

• Hyperreactivity of coronary smooth muscle due to endothelial dysfunction & autonomic imbalance

Clinical presentation

• Young age (<50)
• Minimal CAD risk factors (other than smoking)
• Recurrent chest discomfort
  • At rest or during sleep
  • Spontaneous resolution ≤15 min

Diagnosis

• ECG: ST-segment elevation during episode
• Coronary angiography: no CAD

CAD = coronary artery disease.