Successful Treatment of Refractory Vasospastic Angina With Corticosteroids-Coronary Arterial Hyperreactivity Caused by Local Inflammation?-

Prognostic Value of I-123 Metaiodobenzylguanidine Imaging in Vasospastic Angina Without Significant Coronary Stenosis

“…[1][2][3][4] As a result, recently developed therapies, such calcium antagonists and other drugs, 21 and percutaneous coronary intervention for significant coronary stenosis or drug-resistant spasm, can overcome a poor prognosis for VA. Despite the elimination of these major predictors, there are still some high-risk VA patients who have cardiac events without significant coronary artery stenosis and as shown in the present study, these patients can be identified by MIBG imaging.…”

Successful Treatment of Refractory Angina Pectoris due to Multivessel Coronary Spasm with Valsartan

“…Multivessel coronary spasm is thought to be one of the most severe forms of CSA because simultaneous multivessel coronary spasm is associated with severe and extensive myocardial ischemia (14). Multivessel coronary spasm is often associated with refractory angina (19) (1, 2), β1-adrenoceptor agonists (3) and corticosteroids (4). In this case, the daily administration of 160 mg valsartan was effective in relieving angina that was refractory to conventional medications for coronary spasm.…”

“…or pharmacological interventions other than ordinary antianginal medications, including β1-adrenoceptor agonists (3) and corticosteroids (4). The vascular endothelium is a multifunctional organ that plays an essential role in normal vascular physiology, and endothelial dysfunction may be a critical factor in the pathogenesis of CSA (5,6).…”

Stent Deformity Caused by Coronary Artery Spasm

“…However, coronary artery spasm refractory to the treatment with these drugs is observed in some cases. [1][2][3][4][5][6] Alpha-1 blocking agents, 2 magnesium, 3 benzhexol hydrochloride, 4 denopamine, 5 and nicorandil 6 have been reported as alternatives. Previous reports demonstrated the efficacy of coronary stenting in patients with clinically severe coronary artery spasm refractory to aggressive pharmacologic management.…”

“…[1][2][3][4][5][6] Previous reports demonstrate the usefulness of coronary stents to prevent vasospasm refractory to medical therapy. [7][8][9] However, coronary stent implantation is sometimes ineffective in patients with multivessel spasm.…”