Voenno-medicinskij žurnalVoenno-medicinskij žurnal0026-9050Eco-Vector7282310.17816/RMMJ72823Research ArticlePrinzmetal angina: pathogenesis, clinical presentation, diagnosis, treatmentOvchinnikovYu. V-ShklovskiiB. L3hospital@mail.ruProkhorchikA. Aprocardio@yandex.ruPatsenkoM. B-PyrevA. N-SavrukovaO. A-BaksheevV. I-150120193401192430062021Copyright © 2019, Eco-Vector2019The article outlines the epidemiology of vasospastic angina pectoris (Prinzmetal angina pectoris, variant angina pectoris), its pathogenesis, and current approaches to the diagnosis and treatment of this pathology. Attention is focused on timely diagnosis, which should be comprehensive, taking into account the possible atypical course of Prinzmetal angina pectoris. The important role of ECG monitoring, including using implantable recorders, is shown. It is emphasized that patients with heart rhythm disturbances and syncope are at high risk of developing sudden cardiac death. This category of patients is recommended to timely determine the indications for implantation of a cardioverter-defibrillator. A clinical observation of a patient with Prinzmetal angina is given.vasospastic angina pectorisPrinzmetal angina pectorisvariant angina pectoriscoronary vasospasmsyncopecardiac arrhythmiassudden cardiac deathвазоспастическая стенокардиястенокардия Принцметалавариантная стенокардиякоронарный вазоспазмсинкопенарушения ритма сердцавнезапная сердечная смерть[Фомина И.Г., Матвеев В.В., Галанина Н.А., Перская Е.Л. Стенокардия Принцметала. Новый взгляд на патогенез и подходы к лечению // Кардиоваскулярная терапия и профилактика. - 2006. - Т. 5, № 6. - С. 116-122.][Akhtar M.M., Akhtar R., Akhtar A., Akhtar J. An unusual cause of blackout with transient loss of consciousness: Prinzmetal angina // BMJ. Case Rep., 2012. pii: bcr0120125539.][Beltrame J.F., Crea F., Kaski J.C. et al. Coronary Vasomotion Disorders International Study Group (COVADIS). International standardization of diagnostic criteria for vasospastic angina // Eur. Heart J. - 2017. - Vol. 38, N 33. - P. 2565-2568.][Beltrame J.F., Crea F., Kaski J. et al. Coronary Vasomotion Disorders International Study Group (COVADIS). The Who, What, Why, When, How and Where of Vasospastic Angina // Circ. J. - 2016. - Vol. 80, N 2. - P. 289-298.][ESC guidelines on the management of stable coronary artery disease. The Task Force on the management of stable coronary artery disease of the European Society // Cardiology Eur. Heart J. - 2013. - Vol. 34. - P. 2949-3003.][Hata R., Oka N., Kubo S. et al. Impact of Stent Type and Presence of Vasospastic Angina on Long-Term Prognosis // Circ. J. - 2018. - Vol. 82, N 2. - P. 469-476.][Hung M.J., Hu P., Hung M.Y. Coronary artery spasm: review and update // Int. J. Med. Sci. - 2014. - Vol. 11, N 11. - P. 1161-1171.][Kim S.J., Juong J.Y., Park T.H. Ventricular Tachycardia Associated Syncope in a Patient of Variant Angina without Chest Pain // Korean Circ. J. - 2016. - Vol. 46, N 1. - P. 102-106.][Lee E.M., Choi M.H., Seo H.S. et al. Impact of vasomotion type on prognosis of coronary artery spasm induced by acetylcholine provocation test of left coronary artery // Atherosclerosis. - 2017. - N 257. - P. 195-200.][Ogawa H., Akasaka T., Hattori R. et al. Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary Spastic Angina) (JCS 2013) // Circ. J. - 2014. - Vol. 78, N 11. - P. 2779-2801.][Parikh A., Vacek T.P. Spontaneous Left Main and Right Coronary Artery Spasm in a Patient With Vasospastic Angina // J. Investig. Med. High. Impact Case Rep. - 2017. - Vol. 5, N 3: 2324709617732796. PMID:28989933.][Prinzmetal M., Kennamer R., Merliss R. et al. Angina pectoris I A variant form of angina pectoris: preliminary report // Am. J. Med. - 1959. - Vol. 27. - P. 375-388.][Slavich M., Patel R.S. Coronary artery spasm: Current knowledge and residual uncertainties // Int. J. Cardiol. Heart Vasc. - 2016. - N 10. - P. 47-53.][Takagi Y., Yasuda S., Takahashi J. et al. Japanese Coronary Spasm Association. Clinical implications of provocation tests for coronary artery spasm: safety, arrhythmic complications, and prognostic impact: multicentre registry study of the Japanese Coronary Spasm Association // Eur. Heart J. - 2013. - Vol. 34, N 4. - P. 258-267.][Yasue H., Nakagawa H., Itoh T. et al. Coronary artery spasm-clinical features, diagnosis, pathogenesis and treatment // J. Cardiol. - 2008. - Vol. 51, N 1. - P. 2-17.]