Editorial: Coronary Spasm in Myocardial Infarction: Fact or Fiction?

PATIENTS with variant angina often develop a per-manent coronary artery occlusion at the site of previous "spastic " closures.'-3 In this issue of Circula-tion, Gertz et al.4 demonstrate that a 50 % focal con-striction of a canine coronary or rabbit carotid artery with a suture thread produces extensive endothelial cell damage with thrombus formation. They propose that a similar chain of events may be triggered by coronary artery spasm in variant angina, leading to thrombotic occlusion at the site of spasm and myo-cardial infarction. It can be questioned whether and to what extent a 1-hour constriction of a dissected coronary artery with a suture thread simulates the effects of a brief spasm on an intact artery. The mechanism proposed by Gert