[Coronary spastic angina refractory to optimal medical therapy treated by angioplasty and stenting. A case report and review of literature]. / Angor spastique réfractaire au traitement médical traité par angioplastie avec mise en place d'un stent. A propos d'un cas et revue de la littérature.

Medical treatment of coronary spastic angina is based classically on the association of calcium channel blockers with nitrate derivatives. Some clinical forms of spastic angina remain refractory to these medications and can thus lead to serious complications (sudden cardiac death secondary to ventricular rhythm disturbance, myocardial infarction...). When the coronary spasm is focal, percutaneous coronary angioplasty with deployment of a stent can offer an interesting therapeutic alternative. We report in this article the case of a patient who had a focal spasm of the right coronary artery, which became refractory to optimal medical treatment. This patient was well improved by percutaneous angioplasty with deployment of a stent in the spastic segment of the right coronary artery. We propose also a review of the literature of the treatment of this pathology, which still remains not well codified.