Vasospastic angina: Past, present, and future.

Area of Science:

• Cardiology
• Immunology
• Pathophysiology

Background:

• Vasospastic angina (VSA) is a condition of coronary artery vasospasm causing rest angina, often underdiagnosed due to infrequent provocation testing.
• VSA is a key aspect of non-obstructive coronary artery disease and can range from asymptomatic to presenting with fatal arrhythmias.
• Despite good initial response to vasodilators, patient prognosis in VSA often remains poor, indicating unknown prognostic factors and pathogenesis.

Purpose of the Study:

• To review the theoretical and clinical aspects of VSA.
• To explore the relationship between inflammation, particularly myocarditis, and VSA.
• To offer novel insights into the etiology, diagnosis, and treatment of VSA.

Main Methods:

• Literature review summarizing current understanding of VSA.
• Analysis of the role of inflammation and inflammatory cytokines in VSA development.
• Discussion of VSA's connection to myocarditis.

Main Results:

• Inflammation plays a critical role in the initiation and progression of coronary spasms.
• Inflammatory cytokines demonstrate predictive value in diagnosing VSA.
• Severe or refractory VSA cases are linked to immune-inflammatory responses and may benefit from treatments like glucocorticoids.

Conclusions:

• Inflammation, including myocarditis, is integral to VSA pathogenesis and presents potential diagnostic and therapeutic targets.
• Further research into the inflammatory pathways of VSA is crucial for improving patient outcomes.
• Understanding the link between inflammation and VSA may lead to improved diagnostic strategies and novel treatment approaches.