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We appreciate the reflections of distinguished colleagues on our clinician update1 on coronary artery spasm (CAS) demonstrating that this topic, even if less explored recently in Western literature, is still the focus of clinical and investigational cardiology.Drs Kumar and Kounis and Dr Tsigas et al believe that allergic reactions introducing vasospastic angina, the “syndrome of allergic angina” described in 1991 by Drs Kounis and Zavras and also called the Kounis syndrome, should have been mentioned among the pathophysiological mechanisms inducing coronary spasm. Although we consent to the possible role of this syndrome, the clinician update’s limitation of not exceeding 2000 words and the warning of its …

Response to Letters Regarding Article, “Coronary Artery Spasm: A 2009 Update”