Vasospastic angina is an important cause of chest pain due to coronary artery vasospasm that is related
to poor quality of life and can lead to myocardial infarction, arrhythmias and death. Since its first description as
“Prinzmetal or variant angina” which was believed to be a focal spam that occurred in non-obstructed epicardial
coronary arteries, physician and researchers were gradually confronted with the clinical reality and came to the
conclusion that the coronary artery vasospasm was considerably more polymorphic than initially described. Although
mechanism leading to vasospastic angina is not completely understood, nowadays the medical community
acknowledges that it exhibits a large variability in clinical practice ranging from focal to diffuse epicardial vasospasm.
Main proposed mechanisms are impairment of parasympathetic activity, coronary vascular and microvascular
dysfunction due to blunted response to nitric oxide endothelium-dependent coronary vasodilatation, increased
release of vasoconstricts, and oxidative stress.
Keywords: Coronary vasospasm, angina, coronary microcirculation, endothelial dysfunction, myocardial infarction, epicardial vasospasm.
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