Treatment of Prinzmetal's angina due to coronary artery spasm using verapamil: a report of three cases.

In 3 patients with Prinzmetal's variant angina there were inferior epicardial injury patterns on the electrocardiogram, corresponding to right coronary artery narrowing. Attacks were provoked by beta-adrenergic blockade and stopped by nitroglycerine and atropine. Spasm of the right coronary artery was demonstrated in the 2 patients who had high parasympathetic activity. In all 3 cases attacks disappeared on verapamil. We suggest that calcium-antagonists, which dilate the coronary arteries, should be used in the treatment of Prinzmetal's angina pectoris rather than beta-adrenergic blockers, which do not have this property.