Publication Name	World Journal of Cardiology
Manuscript ID	108594
Country	Australia

Category	Cardiac & Cardiovascular Systems
Manuscript Type	Review
Article Title	Vasospastic angina: Pathophysiology, diagnosis, and emerging therapeutic approaches
Manuscript Source	Invited Manuscript
All Author List	Kristoffer Ken Ralota and Jamie Layland
Funding Agency and Grant Number
Corresponding Author	Jamie Layland, Consultant, FRACP, MD, MRCP, PhD, Professor, Senior Researcher, Department of Medicine, Peninsula Clinical School, Monash University, 2 Hastings Road, Frankston 3199, Victoria, Australia. jlayland@phcn.vic.gov.au
Key Words	Vasospastic angina; Coronary vasospasm; Ischemia with non-obstructive coronary arteries; Coronary microvascular dysfunction; Provocation testing
Core Tip	Vasospastic angina (VSA) is an under-recognized but clinically significant cause of myocardial ischemia, arrhythmia, and sudden cardiac death in patients without obstructive coronary artery disease. This narrative review provides an up-to-date revision of VSA pathophysiology, diagnostic strategies including provocation testing, and current guideline-recommended management. It also highlights promising emerging therapies—such as Rho-kinase inhibitors, endothelin receptor antagonists, and immunomodulatory agents—offering new hope for patients with refractory symptoms. Recognizing and treating VSA proactively can reduce adverse events and improve quality of life in this high-risk yet often overlooked condition.
Citation	Ralota KK, Layland J. Vasospastic angina: Pathophysiology, diagnosis, and emerging therapeutic approaches. World J Cardiol 2025; In press

Received	2025-04-18 05:13
Peer-Review Started	2025-04-18 05:13
To Make the First Decision
Return for Revision	2025-05-17 08:45
Revised	2025-05-31 08:41
Second Decision	2025-09-18 02:54
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-09-19 02:10
Articles in Press	2025-09-19 02:10
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8462 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Copyright	©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com