Successful treatment of vasospastic angina with a coronary stent

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Medicine

Background:

• Coronary artery vasospasm, a cause of angina, is typically managed with calcium antagonists.
• Optimal medical therapy is the first line of treatment for vasospastic angina without significant stenosis.

Observation:

• A patient presented with refractory vasospasm of the right coronary artery despite optimal medical treatment.
• Ergonovine echocardiography confirmed significant vasospasm in the right coronary artery.

Findings:

• Percutaneous coronary intervention (PCI) with stenting of a mild stenosis in the affected artery was performed.
• Post-stenting, a repeat ergonovine echocardiographic test was negative, indicating successful resolution of vasospasm.
• The patient remained asymptomatic one year after the intervention.

Implications:

• Stenting a mild stenosis can be an effective strategy for managing refractory coronary artery vasospasm.
• This approach offers a potential alternative when medical management fails.
• Long-term follow-up suggests sustained efficacy and symptom relief.