Challenging Case in Clinical Practice: An Integrative Approach to Variant Angina.

Variant angina results from coronary vasospasm and is often treated with calcium channel blockers. However, when traditional medical therapies are not tolerated, integrative modalities can be considered. We describe a 57-year-old woman with variant angina, which was confirmed on left heart catheterization with intracoronary nitroglycerin, who could not tolerate diltiazem due to hypotension. Because the patient wanted an integrative approach to her care, she was started on therapies consisting of L-arginine, magnesium, yoga, biofeedback, meditation, acupuncture, optimized sleep hygiene, and moderate intensity exercise. She reported fewer episodes of variant angina at her three-month follow-up visit. This case demonstrates the potential role of integrative therapies in the management of variant angina. Further research is needed to investigate their utility in the management of variant angina and other chest pain syndromes. [ABSTRACT FROM AUTHOR]