Angina associated with severe coronary stenosis is triggered by exercise and relieved by rest. Angina associated with CAS or CMVD is not precipitated by excess cardiac work but by transient impairment of myocardial perfusion. But the common background is always cellular ischaemia and therefore it is difficult to imagine that pushing through might be irrelevant.
Could it damage the heart over time to have repeat CMVD / CAS events?
Both CMVD and CAS may caused prolonged myocardial ischaemia leading to myocardial infarction. So, both mechanisms may be associated with permanent cardiac damage through multiple episodes or prolonged episodes
Can you describe the relationship between CAS, CMVD and Endothelial Dysfunction?
Myocardial ischaemia has been traditionally perceived as the consequence of atherosclerotic obstructions of the coronary vessels. More recently an overwhelming body of evidence has proven that atherosclerotic obstructions are just one of several mechanisms that can precipitate myocardial ischaemia. CAS, CMVD and Endothelial Dysfunction are included among the mechanisms that, in isolated fashion or in combination, may cause myocardial ischaemia
Vasospastic angina: A literature review of current evidence
Fabien Picard, Neila Sayah, Vincent Spagnoi, Julien Adjedj, Olivier Varenne
Lay Summary – updates current understanding of Coronary Artery Spasm to 2018.
https://reader.elsevier.com/reader/sd/pii/S1875213618301323?token=6A57EAB3EE940E9B3D5E99628335EB5D3528FC7A12124C2158354C21CF4508F49F1C3BA68ECFCF7D627A500541B36409
Ischemia and No Obstructive Coronary Artery Disease (INOCA): Developing Evidence-based Therapies and Research Agenda for the Next Decade
C. Noel Bairey Merz, Carl J Pepine, Mary Norine Walsh, Jerome L Fleg
Lay Summary – Discusses the current understanding of INOCA (2017) and the need for future trials and effective therapies
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385930
The expanding spectrum of acute coronary syndromes: from STEMI to coronary dissection and Takotsubo syndrome
Professor Thomas F Lüscher
Lay Summary – What the term Acute Coronary Syndrome should now include.
https://academic.oup.com/eurheartj/article/40/15/1169/5450090
Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association
Jacqueline E Tamis- Holland, Hani Jneid, Harmony R Reynolds, Stefan Agewall, Emmanouil S Brilakis, Todd M Brown, Amir Lerman, Mary Cushman, Dharam J Kumbhani, Cynthia Arslanian-Engoren, Ann F Bolger, John F Beltrame and on behalf of the American Hert Association Interventional Cardiovascular Cre Committee of the Council on Clinical Cardiology; Council on Cardiovascular Care Committee of the Council on Clinical Cardiology; Council on Cardiovascualr and StrokeNursing; Council on Epidemiology and Prevention; Council on Quality of Care and Outcomes Research.
Lay Summary – How to diagnose and treat patients who have had a heart attack but who do not have blocked up arteries.
http://Www.ahajournals.org/doi/full/10.1161/CIR.0000000000000670
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