Management of Coronary Artery Spasm

Calcium channel blockers (CCBs) are the first-line treatment for coronary artery spasm (CAS). When CAS-related angina symptoms not well controlled by CCB therapy, long-acting nitrates or (where available) nicorandil can be added as second-line medications. In case of CAS refractory to standard treatments, several other alternative drugs and interventions have been proposed, including Rho-kinase inhibitor fasudil, anti-adrenergic drugs, neural therapies percutaneous interventions. patients with syncope cardiac arrest caused tachyarrhythmias, even bradyarrhythmias, implantation an ICD pacemaker, respectively, should considered according risk recurrence efficacy vasodilator therapy.