Treatment of Ischemic Heart Disease in Coronary Vasospasm (Prinzmetal Angina)

Ischemic heart disease presenting in the setting of coronary vasospasm — including the pattern known as Prinzmetal or variant angina — represents a distinct clinical sub-population whose management differs from typical obstructive coronary artery disease.

In patients with coronary vasospasm or Prinzmetal (variant) angina, episodes of ischaemia are driven by transient spasm of the coronary arteries rather than fixed atherosclerotic obstruction. The therapeutic approach must directly address this mechanism.

Treatment approach — partial overview

The evidence-based regimen for this scenario is built around calcium channel blockers as the primary pharmacological intervention. The complete protocol — including the full clinical algorithm, sequencing, and all decision points — is available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/suaa060

CAs remain the therapy of choice for patients with coronary vasospasm or Prinzmetal angina.

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