Coronary spasm is a frequent cause of angina despite unobstructed coronary arteries, and symptom control with recommended drugs is limited. We report the case of a 77-year-old woman who had refractory angina despite conventional antianginal treatment. Repurposing riociguat, a soluble guanylate cyclase stimulator, resulted in improvement of symptoms and prevention of spasm. (Level of Difficulty: Intermediate.).
Keywords: ACh, acetylcholine; ECG, electrocardiogram; LCx, left circumflex artery; acetylcholine testing; coronary artery spasm; drug repurposing; individual treatment trial; microvascular dysfunction; riociguat; sGC, soluble guanylate cyclase; soluble guanylate cyclase.
© 2021 The Authors.