Management of Coronary Artery Spasm.

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS European Cardiology Review Pub Date : 2023-01-01 DOI:10.15420/ecr.2022.47
Gaetano Antonio Lanza, Hiroaki Shimokawa
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引用次数: 2

Abstract

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

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冠状动脉痉挛的治疗。
钙通道阻滞剂(CCBs)是治疗冠状动脉痉挛(CAS)的一线药物。当CCB治疗不能很好地控制cas相关心绞痛症状时,可添加长效硝酸盐或(如有)尼可地尔作为二线药物。在标准治疗难治性CAS的情况下,已经提出了几种其他替代药物和干预措施,包括rho激酶抑制剂法舒地尔、抗肾上腺素能药物、神经疗法和经皮冠状动脉介入治疗。对于由cas相关性快速心律失常,甚至慢速心律失常引起的晕厥或心脏骤停患者,应根据复发风险和血管扩张剂治疗效果,分别考虑植入ICD或起搏器。
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来源期刊
European Cardiology Review
European Cardiology Review CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.40
自引率
0.00%
发文量
23
审稿时长
12 weeks
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