Vasospastic Angina: A Contemporary Review of its Pathophysiology, Diagnosis and Management

Area of Science:

• Cardiology
• Vascular Medicine
• Pathophysiology

Background:

• Angina with non-obstructed coronary arteries (ANOCA) affects nearly 40% of patients undergoing cardiac catheterization.
• Coronary artery spasm, a key cause of ANOCA, leads to vasospastic angina (VSA), impacting quality of life and increasing major adverse cardiac events.
• The underlying mechanisms of VSA remain incompletely understood, limiting effective therapeutic strategies.

Purpose of the Study:

• To provide a comprehensive review of the pathophysiological mechanisms of VSA.
• To summarize current therapeutic options for patients with VSA.
• To critically appraise the diagnostic approaches for suspected VSA.

Main Methods:

• Literature review of recent research on ANOCA and VSA.
• Synthesis of information on VSA pathophysiology, diagnosis, and treatment.
• Critical appraisal of diagnostic and therapeutic strategies.

Main Results:

• VSA is a distinct entity within the ANOCA spectrum, characterized by reversible coronary flow attenuation.
• Current understanding of VSA pathophysiology is limited, contributing to a lack of targeted therapies.
• A surge in research over the past decade has improved insights into VSA.

Conclusions:

• Further research into VSA pathophysiology is crucial for developing improved therapeutic options.
• Accurate diagnosis and timely management of VSA are essential for improving patient outcomes.
• This review consolidates current knowledge, guiding future research and clinical practice in VSA.