Many variant angina attacks caused by coronary artery spasm (CAS) resolve on their own. When an attack is ongoing and does not settle spontaneously, a specific clinical protocol applies to terminate the spasm promptly.
An active, ongoing angina attack caused by coronary artery spasm that has not resolved spontaneously and requires direct intervention to terminate the episode.
When a spasm-driven attack persists, the protocol calls for intravenous agents to resolve the coronary artery spasm. The full regimen — including agent selection, sequencing, and all clinical decision points — is detailed in the complete structured protocol.
DOI: 10.15420/ecr.2022.47
Angina attacks caused by CAS usually cease spontaneously or respond quickly to sublingual/buccal short-acting nitrates, such as nitroglycerin 0.3 mg or isosorbide dinitrate (ISDN; 5 mg).
Only in rare cases is the administration of intravenous nitrates or calcium channel blockers (CCBs) necessary to resolve CAS.
View source ↗