Inappropriate Coronary Vasomotion Excessive Constriction and Insufficient Dilation

The possibility that excessive coronary constrictor tone may contribute to myocardial ischemia has recently received increasing attention. The concept of coronary spasm dates back to the nineteenth century, and the study of the history of this pathophysiological entity demonstrates how concepts in cardiology appear to depend strongly upon the popularity of specific diagnostic tools. Unfortunately, this tendency has persisted until recent times, and in the 1970s and 1980s pathophysiological concepts about inappropriate coronary constriction have been dominated by arteriographic observations that are clearly inadequate for the assessment of coronary regulation in health and disease.