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Published on 01.11.2021
Individual response to various calcium channel blockers may differ.
Vasospastic angina diagnostic criteria elements |
Nitrate-responsive angina during spontaneous episodes, with at least one of the following: rest angina – especially between night and early morning; marked diurnal variation in exercise tolerance – reduced in morning; hyperventilation can precipitate an episode; calcium-channel blockers (but not β-blockers) suppress episodes. |
Transient ischaemic ECG changes during spontaneous episodes, including any of the following in at least two contiguous leads: ST-segment elevation ≥0.1 mV; ST-segment depression ≥0.1 mV; new negative U-waves. |
Documentation of coronary artery spasm (>90% constriction) during coronary angiography, spontaneously or in response to a provocative stimulus (typically acetylcholine, ergotamine, or hyperventilation); accompanying transient angina and ischaemic ECG changes (as above). |
Definitive vasospastic angina is diagnosed if nitrate-responsive angina is evident during spontaneous episodes and either the transient ischaemic ECG changes during the spontaneous episodes or coronary artery spasm criteria are fulfilled. |
Suspected vasospastic angina is diagnosed if nitrate-responsive angina is evident during spontaneous episodes but transient ischaemic ECG changes are equivocal or unavailable and coronary artery spasm criteria are equivocal. |
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