China 
Africa 
Explore chapters and articles related to this topic
Nonobstructive Coronary Heart Disease and Coronary Artery Vasospasm
Published in Mark C Houston, The Truth About Heart Disease, 2023
In patients with angina and NO-CHD or CA-VS, the coronary artery spasm is due to a reduction in nitric oxide levels in the artery which increases the resistance in the artery and reduces dilation. Other factors such as vascular inflammation, oxidative stress, and immune dysfunction may also contribute. Depending on the severity and duration of the vasospasm, the patient may have anginal chest pain, tightness, pressure, shortness of breath, or even an MI. This is associated with a worse prognosis. The vasospasm is often triggered by extreme emotional stress, anxiety, anger, high blood pressure, fatigue, high levels of adrenaline or cortisol, tobacco use, exposure to cold, use of illegal stimulant drugs (such as amphetamines and cocaine), hyperventilation, or administration of provocative medications, such as acetylcholine, ergonovine, histamine, or serotonin.
Intracranial haemorrhage
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
v – Vasospasm. Cerebral vasospasm is delayed narrowing of cerebral vessels following a SAH. It normally begins 3 days after the haemorrhage with a peak at 5–14 days. It can cause reduced distal blood flow and can lead to DIND and cerebral infarction if left untreated. It is worth noting that vasospasm on angiography does not necessarily always correlate with clinical symptoms of vasospasm.3
Anatomy, physiology, and histology of the skin
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Vasospasm is the process of constriction of blood vessels by the smooth muscle which surrounds arteries and arterioles. This reduces blood loss in the local area for minutes to hours and is likely triggered by direct damage to smooth muscle, the release of chemokines from activated platelets and reflexes initiated by nociceptors (pain receptors). Adrenaline is a potent vasospastic agent and is released in response to painful stimuli, as well as being included within certain local anaesthetic agents to encourage vasospasm and decrease bleeding. One must be careful, however, when using adrenaline-containing local anaesthetic agents in close proximity to end arteries (such as the angular artery) as its vasospastic effects can cause localised tissue necrosis due to tissue hypoxia. In these regions, it is safest to avoid local anaesthetic solutions which contain adrenaline.
Heparin infusions in aneurysmal subarachnoid hemorrhages: clinical considerations for use beyond anticoagulation
Published in Expert Review of Clinical Pharmacology, 2022
Zsanett Kormanyos, Justin P. Reinert, Paul Brady
Limitations of this evaluation include the discrepancies regarding the definition of vasospasm, cerebral ischemia and delayed neurological deficits in the included studies, as well as the methods used to measure their incidence. There was also a large variability among the included studies of what outcomes were measured, the approach similar outcomes were reported (different disability scales), and in the primary intervention (dose, treatment duration, aPTT goal). The included studies also encompass the treatment approach of the last 20 years. Over this time, the treatment of SAH associated vasospasm has advanced. For example in recent years, ‘triple H’ therapy with induced hypertension, hypervolemia, and hemodilution for the prevention and treatment of vasospasm has fallen out of favor due to significant complications associated with its use, including pulmonary edema, hyponatremia, cerebral edema, and increased cardiac workload leading to myocardial infarction [23]. Surgical and endovascular methods, instruments and techniques are also rapidly evolving posing the question if patient outcomes can truly be directly compared. The Aneurysmal Subarachnoid Hemorrhage Trial Randomizing Heparin (ASTROH) is a phase 2 randomized multicenter trial currently enrolling subjects with low-grade aneurysmal SAH and significant hemorrhage burden undergoing endovascular aneurysm occlusion. The study aims to evaluate functional outcomes and bleeding complications to establish the efficacy and safety of LDIVH [24].
5-Fluorouracil, capecitabine and vasospasm: a scoping review of pathogenesis, management options and future research considerations
Published in Acta Cardiologica, 2022
Eleftherios Teperikidis, Aristi Boulmpou, Panagiotis Charalampidis, Chalil Tsavousoglou, George Giannakoulas, Christodoulos E. Papadopoulos, Vassilios Vassilikos
Prevention strategies with CCB and nitrates have not been effective. Vitamin E, statins and magnesium seemed effective in treating vasospasm in some reports, but the level of evidence is rather low. Nevertheless, their favourable safety profile could make these agents candidates for future prevention strategies. More importantly, the role of L-arginine in preventing 5-FU related vasospasm should be explored further in a clinical trial setting. As described above, 5-FU seems to interfere with RNA synthesis, resulting in a reduction of NOS production by endothelial cells. Administration of L-arginine could provide additional fuel for NO synthesis and could therefore prove to be a valuable addition in prevention strategies, both prior to initiation of treatment as well as in cases of re-challenging.
Feasibility of right coronary artery first ergonovine provocation test
Published in Acta Cardiologica, 2021
Hyun Seok Ham, Ki-Hun Kim, Jino Park, Yeo-Jeong Song, Seunghwan Kim, Dong-Kie Kim, Sang-Hoon Seol, Doo-Il Kim
Table 2 shows the results of the IC ergonovine spasm provocation tests. The mean procedure time was 39.9 ± 11.0 min. Among 725 patients, spasm-positive responses were observed in 269 patients (37.1%), intermediate responses in 113 patients (15.6%), and negative results in 343 patients (47.3%). Definite vasospastic angina was diagnosed in 269 patients (37.1%), and suspected vasospastic angina was in 144 patients (19.9%) according to the definition of JCS. In most cases, the right radial artery approach was used (671 patients, 92.6%). The left radial (22 patients, 3.0%) or the right femoral artery (32 patients, 4.4%) was selected for inaccessible right radial artery cases. The test was mostly performed first on the RCA (689 patients, 95.0%), which led to inundant single vessel spasm (257/269 patients, 95.5%). Significant complications were observed among 24 patients (3.3%) including VT/VF requiring direct current (DC) cardioversion in 12 patients (1.7%), haemodynamically significant hypotension in 8 patients (1.1%), bradyarrhythmia with spontaneous recovery in 3 patients (0.4%), and bradyarrhythmia requiring temporary pacing in 1 patient (0.1%). All complications related with the significant vasospasm were successfully treated, and there was no long-term sequela.