Increased Adventitial Mast Cells in a Patient with Coronary Spasm

ALTHOUGH coronary spasm is an important component of a number of ischemic cardiac syndromes,1 2 3 4 5 6 its cause or causes remain ill-defined. Numerous hypotheses have been considered to explain the mechanisms producing focal vascular hyperreactivity. Our investigations of the autonomic nervous system, and both measurement of thromboxane A2 metabolites and treatment with potent cyclooxygenase inhibitors failed to support the role of thromboxanes in the pathogenesis of coronary spasm.7 8 9 10 Accordingly, we studied the possibility that cellular infiltration of the vessel wall could be a source of vasoconstrictor factors,11 and have now examined coronary vessels in a patient with well-characterized coronary spasm and . . .