March 2025 Br J Cardiol 2025;32(1) doi:10.5837/bjc.2025.014 Online First
Vikram Singh, Roger Clark, Sergey Barsamyan
Introduction Coronary artery spasm (CAS), or Prinzmetal angina, is an increasingly recognised cause of myocardial ischaemia in non-obstructed coronary arteries. It typically presents with anginal chest pain.1 It is rarely associated with myocardial infarction and symptomatic arrythmias.2 It occurs primarily at rest, most commonly in the morning,1,3 and is mostly observed in 40–70-year-old males.4 Prevalence varies by ethnicity, with Japanese ethnicity most strongly linked.5 Atherosclerotic coronary stenosis is an independent risk factor for CAS; more diseased vessels have a higher tendency to spasm in ergonovine provocation testing.6 We des
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