Shedding Light on Treatment Options for Coronary Vasomotor Disorders: A Systematic Review

Cardiovasc Drugs Ther. 2024 Feb;38(1):151-161. doi: 10.1007/s10557-022-07351-x. Epub 2022 Jun 9.

Abstract

Purpose: Coronary vasomotor dysfunction embraces two specific clinical entities: coronary (micro)vascular spasm and microvascular dysfunction. The clinical manifestations of these entities are respectively called vasospastic angina (VSA) and microvascular angina (MVA). Over the years, these diseases have become more and more prominent and several studies aimed to investigate the best diagnostic and therapeutic strategies. Patients with coronary vasomotor disorders are often undertreated due to the absence of evidence-based guidelines. The purpose of this overview is to illustrate the various therapeutic options available for the optimized management of these patients.

Methods: A Medline search of full-text articles published in English from 1980 to April 2022 was performed. The main analyzed aspects of vasomotor disorders were treatment options. We also performed research on "Clinicaltrial.gov" for ongoing trials.

Conclusion: Coronary (micro)vascular spasm and microvascular dysfunction are clinical entities characterized by high prevalence and clinical representation. Several therapeutic strategies, both innovative and established, are available to optimize treatment and improve the quality of life of these patients.

Keywords: Microvascular angina; Non obstructive coronary artery disease; Vasomotor disorders; Vasospastic angina.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Coronary Angiography
  • Coronary Disease*
  • Coronary Vessels / diagnostic imaging
  • Humans
  • Microvascular Angina* / diagnosis
  • Microvascular Angina* / epidemiology
  • Microvascular Angina* / therapy
  • Quality of Life
  • Spasm