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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.<\/jats:p>","DOI":"10.15420\/ecr.2022.47","type":"journal-article","created":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T06:40:22Z","timestamp":1685342422000},"source":"Crossref","is-referenced-by-count":34,"title":["Management of Coronary Artery Spasm"],"prefix":"10.15420","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2187-6653","authenticated-orcid":false,"given":"Gaetano Antonio","family":"Lanza","sequence":"first","affiliation":[{"name":"Fondazione Policlinico A Gemelli IRCCS, Department of Cardiovascular Medicine, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7534-4826","authenticated-orcid":false,"given":"Hiroaki","family":"Shimokawa","sequence":"additional","affiliation":[{"name":"International University of Health and Welfare, Narita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","published-online":{"date-parts":[[2023,5,22]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Prinzmetal M, Kennamer R, Merliss R, et al. 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Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary Spastic Angina) (JCS 2013). Circ J 2014;78:2779\u2013801. https:\/\/doi.org\/10.1253\/circj.cj-66-0098; PMID:\u00a025273915.","DOI":"10.1253\/circj.cj-66-0098"},{"key":"ref66","doi-asserted-by":"publisher","unstructured":"Joy M, Haywood GA, Webb-Peploe MM. Management of a case of refractory variant angina with benzhexol hydrochloride (trihexyphenidyl hydrochloride). Br Heart J 1985;54:448\u201351. https:\/\/doi.org\/10.1136\/hrt.54.4.448; PMID:\u00a04052285.","DOI":"10.1136\/hrt.54.4.448"},{"key":"ref67","doi-asserted-by":"publisher","unstructured":"Schecter AD, Chesebro JH, Fuster V. Refractory Prinzmetal angina treated with cyproheptadine. Ann Intern Med 1994;121:113\u20134. https:\/\/doi.org\/10.7326\/0003-4819-121-2-199407150-00006; PMID:\u00a08017723.","DOI":"10.7326\/0003-4819-121-2-199407150-00006"},{"key":"ref68","doi-asserted-by":"publisher","unstructured":"Krishnan U, Win W, Fisher M. 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Placement of a continuous stellate ganglion block for treatment of refractory ventricular fibrillation in the setting of known Prinzmetal angina during pregnancy: a case report. A A Pract 2019;12:106\u20138. https:\/\/doi.org\/10.1213\/XAA.0000000000000858; PMID:\u00a030102609.","DOI":"10.1213\/xaa.0000000000000858"},{"key":"ref87","doi-asserted-by":"crossref","unstructured":"Abbate A, Hamza M, Cassano AD, et al. Sympathectomy as a treatment for refractory coronary artery spasm. Int J Cardiol 2012;161:e7\u20139. https:\/\/doi.org\/10.1016\/j.ijcard.2012.03.006; PMID:\u00a022465349.","DOI":"10.1016\/j.ijcard.2012.03.006"},{"key":"ref88","doi-asserted-by":"publisher","unstructured":"Grondin CM, Limet R. Sympathetic denervation in association with coronary artery grafting in patients with Prinzmetals\u2019 angina. 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