Very helpful reply, thank you @lisab62 ! I only live 4 hours away from Rochester Mayo Clinic. As soon as I can wrap my head around this diagnosis I may have to look into making a trip to see a cardiologist there. I feel I've just been left hanging in limbo without enough information. I will start a journal as you recommended. Your medication doses are higher than mine, I suppose they may modify them as needed. Thank you for your prayers!

I just requested to join the Facebook support group also.

All you have to do i call (507) 255-2446 Brandy may pick up tell her what you have and ask for the best dr they can recommend for your condition so you can get appointment and paperwork going. Everyone is so nice and helpful. Yes most of my meds are at max. My case is very severe there isn't anything more they can do

Metoprolol mad me much worse in fact that was the medication they put me on that ended up having the Cardiologist that was treating me to refer me to Mayo. Metoprolol is a Beta Blocker not recommend and in fact often makes things much worse. They kept insisting they wanted to try new ones some so at times they tried two more with disastrous affects. "The treatment for coronary vasospasm includes dihydropyridine calcium channel blockers (such as amlodipine or nifedipine), alpha blockers, and avoiding the use of beta-blockers. Animal studies have shown these to be effective, however no human trials have been performed. Beta-blockers are thought to cause “unopposed alpha receptor agonism”. Since the beta receptors would be occupied by the beta-blockers, substances (epinephrine, norepinephrine etc...) can stimulate the alpha receptors more easily causing worsened vasospasm. Avoidance of alpha agonists are important to treat coronary vasospasm. These include pseudoephedrine and oxymetazoline."

Even the insert for it indicates this.
Beta-blockers may increase the number and duration of angina attacks in patients with Prinzmetal's angina (variant angina pectoris). However, relatively selective β1-receptor blockers, such as metoprolol, can be used in such patients, but only with the utmost care.

These are meds that mad the Coronary Artery Spasms worse on me ANGINA Dicyclomine, Ergonovine , Methacholine, Metoprolol, Nebivolol Hcl , Ergot Alkaloids, Isometh-dichloral-acetaminophn

Also when I started on Coq10 I started gettiin worse and it was the Piperine/bioperine
Piperine inhibits metabolizim of Verapamil & Nifedipine reduces the effectiveness thus kicking off the Coronary Artery Spams.
Metabolizing enzymes inhibited or induced by piperine, and a few of the substances whose
bioavailability is affected by these enzymes. Metabolizing Enzymes: CYP1A1, CYP1B1, CYP1B2, CYP2E1, CYP3A4

The Piperine/bioperine is used in some COq10 it help it be absorbed but with heart patient it often affects absorption of med so they are less effective.

@cherfenn, have you had pharmacogenomics testing?

I have brought it up with my PCP and when I see National Jewish this week I will bring it up there as well. My family all has issues with meds so highly likely genetic.