Vasospastic angina diagnostic criteria elements |
1. Nitrate-responsive angina (during spontaneous episode, with at least one of the following): |
- Rest angina, especially between night and early morning
- Marked diurnal variation in exercise tolerance, reduced in morning
- Hyperventilation can precipitate an episode
- Calcium channel blockers (but not beta blockers) suppress episodes
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2. Transient ischemic ECG changes (during spontaneous episode, including any of the following in at least two contiguous leads): |
- ST-segment elevation ≥0.1 mV
- ST-segment depression ≥0.1 mV
- New negative U waves
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3. Coronary artery spasm: Defined as transient total or subtotal coronary artery occlusion (>90% constriction) with angina and ischemic ECG changes either spontaneously or in response to a provocative stimulus (typically acetylcholine, ergot, or hyperventilation) |