Management of Coronary Artery Spasm

Calcium channel blockers (CCBs) are the first-line treatment for coronary artery spasm (CAS). When CAS-related angina symptoms are not well controlled by CCB therapy, long-acting nitrates or (where available) nicorandil can be added as second-line medications. In the case of CAS refractory to standa...

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Main Authors: Gaetano Antonio Lanza, Hiroaki Shimokawa
Format: Article
Language:English
Published: Radcliffe Medical Media 2023-05-01
Series:European Cardiology Review
Online Access:https://www.ecrjournal.com/articleindex/ecr.2022.47
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author Gaetano Antonio Lanza
Hiroaki Shimokawa
author_facet Gaetano Antonio Lanza
Hiroaki Shimokawa
author_sort Gaetano Antonio Lanza
collection DOAJ
description Calcium channel blockers (CCBs) are the first-line treatment for coronary artery spasm (CAS). When CAS-related angina symptoms are not well controlled by CCB therapy, long-acting nitrates or (where available) nicorandil can be added as second-line medications. In the case of CAS refractory to standard treatments, several other alternative drugs and interventions have been proposed, including the Rho-kinase inhibitor fasudil, anti-adrenergic drugs, neural therapies and percutaneous coronary interventions. In patients with syncope or cardiac arrest caused by CAS-related tachyarrhythmias, or even bradyarrhythmias, implantation of an ICD or pacemaker, respectively, should be considered according to the risk of recurrence and efficacy of vasodilator therapy.
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series European Cardiology Review
spelling doaj-art-17d1c3919fb441b4928f8e16643ece5a2024-12-14T16:04:26ZengRadcliffe Medical MediaEuropean Cardiology Review1758-37561758-37642023-05-011810.15420/ecr.2022.47Management of Coronary Artery SpasmGaetano Antonio Lanza0Hiroaki Shimokawa1Fondazione Policlinico A Gemelli IRCCS, Department of Cardiovascular Medicine, Università Cattolica del Sacro Cuore, Rome, ItalyInternational University of Health and Welfare, Narita, JapanCalcium channel blockers (CCBs) are the first-line treatment for coronary artery spasm (CAS). When CAS-related angina symptoms are not well controlled by CCB therapy, long-acting nitrates or (where available) nicorandil can be added as second-line medications. In the case of CAS refractory to standard treatments, several other alternative drugs and interventions have been proposed, including the Rho-kinase inhibitor fasudil, anti-adrenergic drugs, neural therapies and percutaneous coronary interventions. In patients with syncope or cardiac arrest caused by CAS-related tachyarrhythmias, or even bradyarrhythmias, implantation of an ICD or pacemaker, respectively, should be considered according to the risk of recurrence and efficacy of vasodilator therapy.https://www.ecrjournal.com/articleindex/ecr.2022.47
spellingShingle Gaetano Antonio Lanza
Hiroaki Shimokawa
Management of Coronary Artery Spasm
European Cardiology Review
title Management of Coronary Artery Spasm
title_full Management of Coronary Artery Spasm
title_fullStr Management of Coronary Artery Spasm
title_full_unstemmed Management of Coronary Artery Spasm
title_short Management of Coronary Artery Spasm
title_sort management of coronary artery spasm
url https://www.ecrjournal.com/articleindex/ecr.2022.47
work_keys_str_mv AT gaetanoantoniolanza managementofcoronaryarteryspasm
AT hiroakishimokawa managementofcoronaryarteryspasm