Interv Akut Kardiol. 2022;21(3):150-155 | DOI: 10.36290/kar.2022.022

Has the time come to consider expanding functional assessment of coronary circulation?

Vladimír Rozsíval

Kardiologie, Nemocnice Na Bulovce, Praha

Coronary flow is affected by epicardial arterial stenosis, thrombosis, microcirculation, and dynamic changes - dilatation and spasms (1). For several years, emphasis has been placed on flow reserves which are already firmly embedded in our recommendations (2, 3). The opposite of vasodilatation - vasoconstriction - is neglected in the assessment of circulation. Examination of potential spasms is performed only rarely and non-invasively in our catheterization laboratories. Our Guidelines deal with spasms only minimally and marginally (3). The case report mentions provocation of spasm by hyperventilation which resulted in the temporary closure of a large epicardial artery. The discussion section describes the possibilities and potential significance of spasm induction. Finally, we ask whether the provocation of spasms is of clinical significance and whether we will consider incorporating these methods into the Guidelines.

Keywords: coronary spasm, induction of spasms, case report.

Received: June 28, 2022; Revised: July 21, 2022; Accepted: July 22, 2022; Prepublished online: July 22, 2022; Published: November 21, 2022  Show citation