The heart receives its blood supply from coronary arteries, which is divided into right and left major branches. The left coronary artery supplies the bulk of the heart muscle and divides into two divisions: the left anterior descending and left circumflex arteries. The right coronary artery supplies the majority of the right side of the heart and also the sinoatrial (SA) nodal system in most persons. The coronary arteries are medium-sized arteries and have a muscular component that can predispose them to spasm, a function of a muscular artery in the body under physiological and pathological conditions. Coronary artery spasm is a constriction of the coronary artery, due to a variety of causes, which can cause partial or complete occlusion of arterial lumen resulting in limitation of blood flow to myocardium which can cause angina symptoms and can lead to significant deleterious effects like myocardial ischemia, infarction, arrhythmias, and even sudden cardiac death.
Microembolization occludes small vessels, which often leads to microvascular dysfunction and development of back pressure in the coronary tree, which can also lead to myocardial ischemia and its accompanying symptoms. Microembolization usually occurs in the setting of existing coronary artery disease with fragments of a plaque that is disturbed, spontaneously or due to coronary intervention, which then progresses to micro-circulation and clogs up the small arterioles and capillaries.
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