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Canadian Journal of Cardiology
Letters to the Editor|Articles in Press

Panic Attack Causes Coronary Microvascular Spasm?

Published:March 03, 2023DOI:https://doi.org/10.1016/j.cjca.2023.02.019
      I read with interest Irfan and colleagues’ case report

      Irfan, S., McCarthy, M. & Miner, S. Association Between Panic Attack and Coronary Ischemia Due to Reduction in Coronary Blood Flow. Can J Cardiol 39, 71-72 (2023). https://doi.org:10.1016/j.cjca.2022.09.005

      on purported coronary microvascular spasm and panic attack during a functional coronary angiogram. The patient did not stop her calcium channel blocker on the day of procedure. This could confound the procedure, i.e. blunting either coronary epicardial or microvascular spasm if acetylcholine was given, which was not. Neither was adenosine administered. How then was the coronary flow reserve (CFR) of 1.9 derived? CFR is a hyperaemic index and this value suggests impaired vasodilatory capacity.
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      References

      1. Irfan, S., McCarthy, M. & Miner, S. Association Between Panic Attack and Coronary Ischemia Due to Reduction in Coronary Blood Flow. Can J Cardiol 39, 71-72 (2023). https://doi.org:10.1016/j.cjca.2022.09.005

      2. McLaughlin, D. P., Wu, S. S. & Stouffer, G. A. in Cardiovascular Hemodynamics for the Clinician (ed G. A. Stouffer) Ch. 21, 233-224 (Blackwell Publishing, 2008).