Stent implantation for diffuse and multiple coronary spasm in a patient with variant angina refractory to optimal medical therapy.

A patient with variant angina presented complaining of frequent morning chest pain refractory to maximal doses of 5 vasodilator agents. His condition was complicated by a drug eruption due to a side effect of the calcium antagonist. Coronary angiography showed no organic stenosis, but a challenge test revealed multiple and diffuse coronary artery spasms at the right coronary artery and the left anterior descending artery. A total of 5 stents were implanted for full coverage of the spastic segments. Spasm could not be provoked by repeating the challenge test after stenting. He has been asymptomatic for 8 months since the procedure.