{"title":"Coronary Artery Spasm as a Contributor to Heart Failure: Lessons from Three Cases.","authors":"Ayami Naito, Takumi Toya, Akane Kawai, Kota Mizutani, Kazuhiko Kuinose, Yuji Nagatomo, Takeshi Adachi","doi":"10.2169/internalmedicine.5057-24","DOIUrl":null,"url":null,"abstract":"<p><p>Coronary artery spasm (CAS) is an underrecognized cause of heart failure, even in the absence of obstructive coronary artery disease. We report three cases of heart failure in which CAS was identified as the critical etiology. All patients exhibited symptoms of heart failure with nonobstructive coronary arteries, and CAS provocation testing confirmed epicardial spasm. In two cases, cardiac magnetic resonance imaging revealed ischemic patterns consistent with CAS-related injuries. Calcium channel blockers effectively stabilize the signs and symptoms related to heart failure. This series highlights CAS as a contributor to heart failure progression and emphasizes the importance of provocation testing and early tailored therapy for improving outcomes.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2169/internalmedicine.5057-24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Coronary artery spasm (CAS) is an underrecognized cause of heart failure, even in the absence of obstructive coronary artery disease. We report three cases of heart failure in which CAS was identified as the critical etiology. All patients exhibited symptoms of heart failure with nonobstructive coronary arteries, and CAS provocation testing confirmed epicardial spasm. In two cases, cardiac magnetic resonance imaging revealed ischemic patterns consistent with CAS-related injuries. Calcium channel blockers effectively stabilize the signs and symptoms related to heart failure. This series highlights CAS as a contributor to heart failure progression and emphasizes the importance of provocation testing and early tailored therapy for improving outcomes.
期刊介绍:
Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine.
Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.