Coronary stenting in patients with medically resistant vasospasm

Rev Cardiovasc Med. 2010 Fall;11(4):264-70. doi: 10.3909/ricm0545.

Abstract

Formally described by Prinzmetal and colleagues in 1959, variant angina represents a syndrome of resting angina that results from severe coronary artery vasospasm associated with ST elevation. The majority of patients respond to nitrates or calcium channel blockers. However, medical treatment-resistant vasospasm can occur in up to 20% of cases, thus requiring further interventions. We present a rare instance of coronary vasospasm associated with complete heart block resistant to medical therapy that was successfully treated with stenting. This case example is followed by a detailed review of the literature with regard to percutaneous or surgical coronary revascularization of patients with medically resistant vasospasm.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Angina Pectoris, Variant / diagnosis
  • Angina Pectoris, Variant / etiology*
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Coronary Angiography
  • Coronary Vasospasm / complications
  • Coronary Vasospasm / diagnosis
  • Coronary Vasospasm / drug therapy
  • Coronary Vasospasm / therapy*
  • Drug Resistance*
  • Electrocardiography
  • Humans
  • Male
  • Severity of Illness Index
  • Stents*
  • Treatment Outcome
  • Ultrasonography, Interventional
  • Vasodilator Agents / therapeutic use*

Substances

  • Vasodilator Agents