title: [Diagnosis of the dynamic lesion].
abstract: Rupture of atheromatous plaques, thrombosis and spastic contractions cause dynamic lesions in coronary arteries. This review focuses on the diagnostic approach to vasospastic lesions. Our current knowledge considers vasospastic angina as a--most likely--localized disease of the vascular smooth muscle, which occurs in nonatherosclerotic as well as in atherosclerotic segments. Currently the diagnosis can only be proven by functional tests under angiographical control. Since the pathophysiological mechanisms leading to vasospasm remain unclear, only empirically developed pharmacological tests are available. The use of ergonovine alkaloids is well established, the feasibility of acetylcholine is under investigation. The reproducibility regarding the course of the disease and the localization of the lesion has not yet been determined. The necessity to state the diagnosis is given by the improved prognosis of the disease under effective therapy with calcium channel blockers and nitrates.
authors.affiliation: Klinik für Innere Medizin-Kardiologie, Deutsches Herzzentrum Berlin.
authors.forename: E
authors.initials: E
authors.lastname: Fleck
authors.forename: W
authors.initials: W
authors.lastname: Auch-Schwelk
authors.forename: E
authors.initials: E
authors.lastname: Frantz
authors.forename: F
authors.initials: F
authors.lastname: Krackhardt
authors.forename: H
authors.initials: H
authors.lastname: Oswald
authors.forename: H U
authors.initials: HU
authors.lastname: Sauer
mesh_terms: D000109:Acetylcholine; D000788:Angina Pectoris, Variant / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D000789:Angina, Unstable / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D003329:Coronary Vasospasm / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D004874:Ergonovine; D006801:Humans; D005996:Nitroglycerin / Q000008:administration & dosage
chemical_list: D005996:Nitroglycerin; D000109:Acetylcholine; D004874:Ergonovine
vernacular_title: Diagnostik der dynamischen Läsion.