[Current views on the clinical significance of coronary artery spasm]

Current views about etiology, pathogenesis, diagnostics and treatment of coronary artery spasm have been presented. A lot of researches show complexity of factors, which are responsible for coronary artery spasm. The most important are: a local hypersensitivity of vessels wall, neurogenic factors and humoral factors. The lack of magnesium plays also important role. Clinical manifestations of coronary artery spasm are: Printzmetal's angina, arrhythmia, acute myocardial infarction, atypical chest pain and cardiac sudden death. Among diagnostic examination the main importance have provocative tests with ergonovine and acetylcholine, rarely hyperventilation and cold are used. Calcium channel blockers, nitrate, molsidomine are employed in treatment patients with coronary artery spasm. There are taken modern examinations of new drugs like beta-1 adrenergic agonists and derived molsidomine agents. Beta-adrenergic blocking agents are contraindicated. It has been emphasized, that early diagnostics and pharmacologic treatment improve long-term prognosis in this group of patients.