[Vasosspastic angina: current concepts about pathogenesis, diagnosis, treatment (literature review).]

Abstract

The review examines risk factors, triggers, diagnostic approaches, treatment and preventive strategies for vasospastic angina (VSA). Transient coronary spasm plays an important role in the pathogenesis of stable angina and acute coronary syndromes. Among the factors in the pathogenesis of VSA, the most relevant are sympatho-vagal imbalance, endothelial dysfunction, hypercontractility of smooth muscle cells of the coronary arteries, intravascular and perivascular inflammation, and genetic predisposition. The review provides diagnostic criteria for VSA based on clinical manifestations, electrocardiographic data and angiographic documentation of coronary spasm. Indications and contraindications for intracoronary administration of vasospasm provoking agents are described. Current ideas about traditional and innovative (including interventional) approaches to the treatment and prevention of VSA are revealed. Insufficient study of the problem of VSA in elderly and senile patients has been noted. The factors that have the most adverse impact on the quality of life and prognosis in patients with recurrent coronary spasm are identified.