Cardiology pp 431-450 | Cite as

Dynamic Coronary Stenosis: The Elusive Link between Coronary Atherosclerosis and Clinical Manifestations of Ischaemic Heart Disease

  • Attilio Maseri


Recent concepts on the roles of dynamic coronary stenosis in ischaemic heart disease are reviewed, with particular reference to episodes of transient myocardial ischaemia and their implications for patient management and therapy. The possible contribution of spasm and other obstructive mechanisms, such as platelet aggregation and thrombosis, to the various forms of angina pectoris, to myocardial infarction and sudden death are analysed in the light of clinical experience and clinical investigations. Based on these conceptual and clinical considerations, guidelines are suggested for future research and therapy. Long-term treatment with nitrates and calcium antagonists, which appear to be effective in preventing dynamic stenoses, resulted in low mortality and infarction rates over a period of two to four years, in a group of patients with ischaemic heart disease at high risk.


Angina Pectoris Ischaemic Heart Disease Coronary Flow Reserve Isosorbide Dinitrate Coronary Spasm 
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© Springer Science+Business Media New York 1984

Authors and Affiliations

  • Attilio Maseri
    • 1
  1. 1.Hammersmith HospitalRoyal Postgraduate Medical SchoolLondonUK

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