The Prevalence of Silent Coronary Artery Spasm in Patient with Chronic Heart Failure

There have been few reports concerning the correlation between heart failure and coronary artery spasm. But, in recent years, some studies have reported coronary artery spasm may result in a small percentage of patients with chronic heart failure of unknown origin. So we examined the ratio of coronary artery spasm in patient with chronic heart failure and the clinical characteristics. Between April 2014 and March 2016, 17 patients with chronic heart failure but without any coronary stenosis or any valvular diseases were enrolled. An acetylcholine(Ach) provocation test was performed to investigate the etiology of heart failure. Coronary spasm in patient with heart failure was recognized in 10 patients (58%) out of 17 patients. Ischemic ECG change was observed in 5 patients (50%) out of 10 patients during spasm provocation test. On the other hand all of these patients did not have typical chest pain duringspasm provocation test. In addition, they had not experienced angina chest pain prior to hospital visiting. This suggests that coronary spasm related to heart failure is an almost silent ischemia. So we should perform spasm provocation test in patients with unknown origin of heart failure and no fixed stenosis. And also the existence of coronary spasm should be considered when beta blocker was administered to the patients with chronic heart failure.