Which medication is best for coronary spasms? Struggling with this after anterior STEMI and stents and severe allergic reaction to some meds

What medication options have people experienced for coronary spasms? I have terrible time with this following anterior STEMI and stents

[Hidden]

I experience spasms after having a stent fitted to my LCX, my cardiologist switched me from Bisoprolol to Amlodipine which has definitely helped a lot.

[Hidden in reply to Hidden]

Thanks for that. Yes I was switched from Bisoprolol to Diltiazem. Unfortunately I had a severe allergic drug reaction about 3 weeks after starting. Put back on Bisoprolol - spasms/ angina became intolerable. Cardiologist annoyed the Diltiazem stopped so asked me to try them again. 24 hours later massive reaction again. Hospital put me back on Bisoprolol. Cardiologist advised. As a result he has changed meds again so that I’m not on Bisoprolol. New meds causing nausea and major headaches but need to adjust - put on Ivabradine twice a day and the mono nitrate tablets. Fingers crossed as getting down with all this

[Milkfairy Heart Star in reply to Hidden]

Hello Luisbrady

I have lived with coronary vasospasms since 2012.

I don't have any blockages just very fickle blood vessels prone to go into spasm.

Beta blockers are well known to make coronary vasospasms worse. A well meaning Cardiologist prescribed beta blockers and I ended up in hospital with a very severe episodes of vasospasms.

I can't live without

Diltiaziem slow release tablets,

Isosorbide mononitrate extended release tablets and patches

Nicorandil.

It can take time and patience to find the best combination of medication to help you most.

Once you get a good combination politely tell the on call Cardiologists not to mess with your tablets!

I also suggest you keep a diary of your symptoms to see if you can spot any pattern or triggers.

Mine are the cold, emotional and mental stress.

The BHF has this information about Vasospastic angina the term that is beginning to used more often rather than coronary artery spasms.

bhf.org.uk/informationsuppo...

There is also a growing recognition of coronary vasospasms causing a problem after stents have been inserted.

academic.oup.com/eurheartjs...

[Hidden in reply to Milkfairy]

Thank you so much for your helpful comments. I did feel the Diltiazem were working it’s just a shame I react so badly to them - ended up being sent to a specialist dermatologist at a different hospital for emergency treatment and biopsy. The biopsy confirmed just two weeks ago that it was severe lichenoid eruption due to the drug I was sure there was another alternative to Diltiazem but for now I will try the new meds prescribed by my cardiologist. I have managed two nights now without being woken up to 4 times with severe angina. 🤞. I think stress plays a large part in all this sadly. Thanks again

[Milkfairy Heart Star in reply to Hidden]

There are other Calcium channel blockers such as Amlodipine which Boo_Boo mentioned also Verapamil.

It's a shame if you can't tolerate Diltiaziem.

I wish you more angina free nights.

I hate being woken up from a deep sleep with angina!

[Hidden in reply to Milkfairy]

I was hoping they might suggest Verapamil! It’s so difficult when you can’t see cardiologist face to face to discuss things - Just not the same on the phone. Thanks for response