[Can beta-receptor blockers trigger coronary spasm?]

Beta-blockers are frequently administered in therapy of arterial hypertension and coronary heart disease. They mostly lead to an asymptomatic increase of peripheral and coronary resistance. Three patients in whom there were indications of a deterioration of myocardial blood flow under beta-blockade were observed within a few weeks. After discontinuation of the beta-blockers and instituting a therapy with calcium antagonists, both a reduction of ischemia in the exercise ECG and a reduction of symptoms could be observed. The possibility that beta-blockers trigger coronary spasms and thus give rise to unfavorable effects on myocardial blood flow must be considered in the context of therapy monitoring, especially in patients with coronary heart disease.