Vasospastic Angina as a Cause of Post-Acute Sequelae of COVID-19

Diagnosing the cause of post-acute sequelae of COVID-19 (PASC, also known as long COVID)-related chest pain is often challenging in patients with a low pre-test probability of coronary artery disease. In a retrospective review of 273 consecutive patients who presented to the cardiovascular outpatient unit for cardiovascular PASC at the Hokkaido Cardiovascular Hospital, Japan, 8 patients were suspected to have vasospastic angina (VSA) and underwent acetylcholine provocation testing, 5 of whom (1.8%, 5/273) were newly diagnosed with VSA. Although the causal relationship between VSA and PASC should be studied further, the present study suggests that VSA can be a potential cause of chest pain in patients with PASC.