Chronic coronary syndrome (CCS) most commonly presents as chronic stable exertional angina or ischemic cardiomyopathy with heart failure as the primary manifestation. Some patients are in a stable phase after experiencing acute coronary syndrome (ACS) or undergoing revascularization, while others may have asymptomatic latent coronary artery disease.
The primary cause of myocardial ischemia in CCS is the presence of stable atherosclerotic plaques in the epicardial coronary arteries, leading to fixed stenosis. Myocardial ischemia and hypoxia are typically triggered by factors that increase myocardial oxygen demand, resulting in transient and acute ischemia. However, cases of coronary artery spasm or microvascular disease without fixed stenosis in the epicardial vessels are also commonly observed in clinical practice.
In terms of treatment, CCS patients share common therapeutic goals: alleviating symptoms through anti-ischemic therapy, stabilizing or reversing atherosclerotic plaques, preventing thrombus formation, and ultimately prolonging survival.
To be continued