caa a22 4500 606158596 CHVBK 20210128100620.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s10557-015-6595-4 doi (NATIONALLICENCE)springer-10.1007/s10557-015-6595-4 Vasotonic Angina as a Cause of Myocardial Ischemia in Women [Elektronische Daten] [Edina Cenko, Raffaele Bugiardini] The frequency, presentation, prognosis, and treatment of myocardial ischemia differ in men and women. A large proportion of women who have "normal” coronary arteries on angiography without any significant evidence of flow-limiting disease also have biochemical or imaging evidence of myocardial ischemia. In these women it is believed to be a dysfunction of coronary microcirculation and/or macrocirculation, or vasotonic angina (VA), that leads to abnormal vasoconstriction, and potentially to myocardial infarction, ventricular arrhythmias, and sudden death. Despite having a "normal” or near normal coronary angiography, these women should therefore undergo additional testing with acetylcholine to assess endothelial function. Long-term survival is believed to be relatively good. Predictors of poorer prognosis include documentation of severe endothelial dysfunction and presence of concurrent angiographycally visible coronary atherosclerosis. Because atherosclerosis is common in patients with VA, medical and lifestyle interventions for preventing or treating atherosclerosis should be implemented when appropriate. Angiotensin converting enzyme inhibitors are the mainstays of medical therapy for VA. Other agents have been tried with variable success, including beta-blockers. There are no available data on any specific treatment of VA in women (versus men). Springer Science+Business Media New York, 2015 Vasotonic angina nationallicence Cardiac syndrome X nationallicence Non-obstructive coronary artery disease nationallicence Women nationallicence Cenko Edina Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 9, c/o Policlinico Sant'Orsola Malpighi (Padiglione 11), 40138, Bologna, Italy aut Bugiardini Raffaele Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 9, c/o Policlinico Sant'Orsola Malpighi (Padiglione 11), 40138, Bologna, Italy aut Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/4(2015-08-01), 339-345 0920-3206 29:4<339 2015 29 10557 https://doi.org/10.1007/s10557-015-6595-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10557-015-6595-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cenko Edina Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 9, c/o Policlinico Sant'Orsola Malpighi (Padiglione 11), 40138, Bologna, Italy aut NATIONALLICENCE 700 1- Bugiardini Raffaele Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 9, c/o Policlinico Sant'Orsola Malpighi (Padiglione 11), 40138, Bologna, Italy aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/4(2015-08-01), 339-345 0920-3206 29:4<339 2015 29 10557