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Refractory Vasospastic Angina: When Typical Medications Don't Work.

Varun Tandon1, Christian M Mosebach1, Manish Kumar1

  • 1Internal Medicine, University of Connecticut, Farmington, USA.

Cureus
|May 7, 2019
PubMed
Summary

Refractory vasospastic angina (VSA) presents a challenge when standard treatments fail. This case highlights unconventional methods for managing VSA unresponsive to typical medications, offering insights for difficult cases.

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Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Vasospastic angina (VSA) involves coronary artery spasm causing myocardial ischemia.
  • Standard treatment includes calcium-channel blockers (CCBs) and nitrates.

Observation:

  • A patient with a history of myocardial infarction presented with recurrent angina.
  • Coronary angiography revealed acute vasospasm refractory to initial treatment.

Findings:

  • The patient was diagnosed with refractory VSA, unresponsive to optimal medical therapy.
  • Intracoronary vasodilators provided temporary relief, necessitating unconventional approaches.

Implications:

  • This case underscores the need for alternative strategies in refractory VSA.
  • Further research into managing refractory VSA is warranted due to limited data.
Keywords:
acute coronary syndromenstemiprinzmetal anginarefractory vasospastic anginastemivasospastic angina

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