Coronary vasospasm after myocardial revascularisation. Treatment by verapamil

Coronary vasospasm occurring after myocardial revascularisation must be quickly and efficiently treated to avoid the haemodynamic complications that it may cause. Treatment by nitroglycerin intravenously (i.v.) is not always efficient and an alternate possibility of treatment is essential. During the period from March 1982 to August 1983, we observed in our institution three patients with coronary vasospasms occurring after myocardial revascularisation which did not respond to nitroglycerin i.v. and were successfully treated by verapamil. Recurrence of vasospasm was prevented in those cases by verapamil perfused i.v. (dosage: 0.37 to 0.75 microgram/kg/min). The clinical evolution of these 3 cases are described here. Dosages of verapamil used to treat and to prevent the incident are discussed. The limitations of this therapy are briefly reviewed.