Calcium channel antagonists and nitrates remain the mainstay of therapy for coronary artery spasm, though management of refractory cases and risk stratification for primary prevention ICDs remain uncertain.
This review highlights the diagnostic challenges and therapeutic strategies for coronary artery spasm, emphasizing the need for individualized management in refractory cases and high-risk patients.
Myocardial ischaemia results from a direct mismatch between oxygen supply and demand, commonly arising as a result of coronary atherosclerosis, microvascular dysfunction or acute thrombosis and luminal obstruction. However, transient ischaemia may also occur due to coronary spasm leading to acute and unexpected myocardial ischaemia without obvious visible coronary pathology. Aside from symptoms of chest pain, coronary spasm can cause infarction, LV impairment, promote life threatening arrhythmias and ultimately sudden cardiac death. While therapeutic options are available, controversies exist around diagnosis, pathology, management and prognosis. This review summarises some of the common questions in this area. In particular we explore and discuss the available evidence for the pharmacological treatment of coronary spasm, and strategies for identification and management of very high risk patients to try and reduce the incidence of sudden premature death.
Slavich et al. (Sat,) conducted a review in Coronary artery spasm. Calcium channel antagonists and nitrates was evaluated. Calcium channel antagonists and nitrates remain the mainstay of therapy for coronary artery spasm, though management of refractory cases and risk stratification for primary prevention ICDs remain uncertain.