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Coronary Spasm

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https://www.readbyqxmd.com/read/29321418/optimal-medications-and-appropriate-implantable-cardioverter-defibrillator-shocks-in-aborted-sudden-cardiac-death-due-to-coronary-spasm
#1
Shozo Sueda, Hiroaki Kohno
Background Life-threatening ventricular arrhythmias are recognized in patients with coronary spastic angina. Implantable cardioverter-defibrillators (ICDs) are effective in patients with structural heart disease and ventricular fibrillation. However, the optimal medication for patients with aborted sudden cardiac death (SCD) due to coronary artery spasm after the implantation of ICD remains controversial. Methods We investigated the medications and the numbers of appropriate ICD shocks in 137 patients with a history of aborted SCD due to coronary spasm...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29316984/coronary-artery-spasm-due-to-intravenous-atropine-infusion-in-a-child-possible-kounis-syndrome
#2
Ana Castellano-Martinez, Moises Rodriguez-Gonzalez
Coronary vasospasm can result from silent myocardial ischaemia to sudden death. There are many precipitant factors including different pharmacological agents. Kounis syndrome is defined by acute coronary syndromes associated with anaphylactic or anaphylactoid reactions. We report, to the best of our knowledge, the first paediatric case of Kounis syndrome due to intravenous atropine.
January 10, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29315085/biopsy-confirmed-endothelial-cell-activation-in-patients-with-coronary-microvascular-dysfunction
#3
Hannes Lindemann, Ivana Petrovic, Stephan Hill, Anastasios Athanasiadis, Heiko Mahrholdt, Tim Schäufele, Karin Klingel, Udo Sechtem, Peter Ong
BACKGROUND: Patients with angina yet having unobstructed coronaries are found in ∼50% of cases undergoing invasive angiography. Coronary spasm and microvascular dysfunction can be responsible for the clinical presentation in ∼60% of cases. However, little is known about structural changes in the myocardium. The aim of this study was to describe findings in endomyocardial biopsies of symptomatic patients with unobstructed coronaries. PATIENTS AND METHODS: We retrospectively analyzed a cohort of 1416 consecutive patients who underwent endomyocardial biopsy sampling and coronary angiography between 2002 and 2016 for various clinical indications...
January 8, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29306669/balloon-assisted-tracking-a-practical-solution-to-avoid-radial-access-failure-due-to-difficult-anatomical-challenges
#4
Ioannis Felekos, Rafaqat Hussain, Sundip J Patel, Antonis N Pavlidis
AIM: The balloon assisted tracking (BAT) technique is utilised to overcome various anatomical difficulties during radial procedures when standard measures such as adequate sedation, pain relief, vasodilators and use of hydrophilic guidewires, fail. The aim of this study was to evaluate the success rates of the BAT technique in overcoming anatomical difficulties during radial coronary interventional procedures. METHODS: We retrospectively reviewed 1100 consecutive patients undergoing coronary procedures from the transradial approach (TRA) between May 2015 and May 2017...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29300076/modified-carbodissection-a-new-technique-for-harvesting-the-internal-mammary-artery
#5
Shegu Gilbert, Devender Singh, M K Sivakumar
The modified carbodissection technique is a new technique for harvesting the internal mammary artery during coronary artery bypass graft surgery. It is performed using an improvised instrument that consists of an electrocautery device and a carbon dioxide blower/mister. It combines electrocautery dissection and continuous controlled gas blow dissection along with saline irrigation mist. Gas dissection causes vasodilation and maintains the artery in a dilated state during dissection. Saline flow reduces the amount of heat generated at the cautery site and prevents drying and desiccation of the tissues...
October 29, 2017: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29299356/fluoropyrimidine-induced-cardiac-toxicity-challenging-the-current-paradigm
#6
Suparna C Clasen, Bonnie Ky, Rupal O'Quinn, Bruce Giantonio, Ursina Teitelbaum, Joseph R Carver
Background: Fluoropyrimidine chemotherapy [5-fluorouracil (5-FU) and capecitabine] are commonly used agents in the treatment of various solid malignancies. However, their use has been limited by cardiac toxicity, presenting as a wide spectrum of asymptomatic (e.g., EKG changes) and symptomatic (e.g., chest pain) manifestations related to coronary vasospasm leading to myocardial ischemia. Historically, patients with suspected coronary vasospasm have been treated with traditional acute ischemic workup and various combinations of anti-anginal therapies...
December 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29249438/clinical-outcome-according-to-spasm-type-of-single-coronary-artery-provoked-by-intracoronary-ergonovine-tests-in-patients-without-significant-organic-stenosis
#7
Dae-Won Kim, Sung-Ho Her, Youngkeun Ahn, Dong Il Shin, Seung Hwan Han, Dong-Soo Kim, Dong-Ju Choi, Hyuck Moon Kwon, Hyeon-Cheol Gwon, Sang-Ho Jo, Seung-Woon Rha, Sang Hong Baek
BACKGROUND: This study aimed to evaluate clinical implications of single vessel coronary spasm provoked by intracoronary ergonovine provocation test in Korean population. METHOD: A total of 1248 patients who presented with single vessel coronary artery spasm induced by intracoronary ergonovine provocation test, excluding 1712 with negative spasms, multiple and mixed coronary artery spasms and missing data among 2960 patients in the VA-KOREA (Vasospastic Angina in Korea) registry, were classified into diffuse (n=705) and focal (n=543) groups...
February 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29248270/acute-myocardial-infarction-due-to-simultaneous-spasm-of-3-coronary-arteries-that-worsened-over-time
#8
Takuya Shimizu, Ken Umetani, Yu Murata, Tomoko Harama, Toshiaki Yano, Aritaka Makino, Keita Sano, Masahiko Nakamura
Coronary artery spasm (CAS) rarely worsens from single-vessel to simultaneous multivessel CAS naturally, and simultaneous multivessel CAS leads to serious conditions such as cardiopulmonary arrest (CPA). A 77-year-old Japanese man who took medications for CAS was transferred to our hospital due to persistent chest pain. On arrival, his vital signs were stable, but his electrocardiogram (ECG) showed ST-segment elevation in leads II, III and aVF. Ventricular fibrillation developed suddenly. Although routine cardiopulmonary resuscitation (CPR) including intravenous administration of epinephrine was performed immediately, he could not be resuscitated...
December 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29238609/blunted-heart-rate-recovery-is-associated-with-coronary-artery-spasm-in-patients-with-suspected-vasospastic-angina
#9
Hyunsu Kim, Sang-Hoon Cho, Kyoung-Im Cho, Bong-Joon Kim, Sung-Il Im, Jung-Ho Heo
Background: Autonomic nervous system activity has been shown to be altered in patients with vasospastic angina (VA). Heart rate recovery (HRR) is a simple, non-invasive measurement of autonomic nervous system dysfunction. We aimed to investigate whether HRR is related to VA, as established by an ergonovine test. Methods: A total of 976 consecutive patients (47.5% male, mean age 55 years) without significant coronary artery disease who underwent both an ergonovine provocation test and a treadmill exercise test were enrolled...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/29236216/long-term-outcomes-of-a%C3%A2-caucasian-cohort-presenting-with-acute-coronary-syndrome-and-or-out-of-hospital-cardiac-arrest-caused-by-coronary-spasm
#10
W Vlastra, M Piek, M A van Lavieren, M E J C Hassell, B E Claessen, G W Wijntjens, T P van de Hoef, K D Sjauw, M A Beijk, R Delewi, J J Piek
BACKGROUND: Coronary artery spasm may be the underlying mechanism in up to 10% of cases of acute coronary syndrome (ACS) and sudden cardiac death. Asian individuals exhibit a 3-times greater incidence of spasm than Caucasians; this is likely due to different types of mechanisms. Consequently, solid data is limited about the long-term prognosis in Caucasian patients presenting with ACS and/or out-of-hospital cardiac arrest (OHCA) caused by coronary spasm. METHODS: Between 2002 and 2015, thirty Caucasian patients with coronary artery spasm presenting with ACS (N = 29) and/or OHCA (N = 11) were enrolled in this prospective registry...
December 13, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29230572/responsiveness-of-internal-thoracic-arteries-to-nitroglycerin-in-patients-with-renal-failure
#11
Masashi Tawa, Takeshi Kinoshita, Tohru Asai, Tomoaki Suzuki, Takaharu Ishibashi, Tomio Okamura
Nitroglycerin is commonly used as an antispasmodic for treating spasm of coronary artery bypass grafts. This study investigated whether the presence of renal failure affects reactivity to nitroglycerin in internal thoracic arteries obtained from patients undergoing coronary bypass surgery. The patients were divided into three groups according to estimated glomerular filtration rate (eGFR, mL/min/1.73 m2): without renal failure (60 ≤ eGFR, n = 13), with moderate renal failure (30 ≤ eGFR < 60, n = 10), and with severe renal failure (eGFR < 30, n = 10)...
December 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29228159/patients-with-acute-myocardial-infarction-and-non-obstructive-coronary-arteries-safety-and-prognostic-relevance-of-invasive-coronary-provocative-tests
#12
Rocco A Montone, Giampaolo Niccoli, Francesco Fracassi, Michele Russo, Filippo Gurgoglione, Giulia Cammà, Gaetano A Lanza, Filippo Crea
Aims: Functional alterations of epicardial coronary arteries or coronary microcirculation represent a frequent cause of myocardial infarction and non-obstructive coronary arteries (MINOCA). We aimed at assessing the prognostic value of intracoronary provocative tests in patients presenting with MINOCA and in which other causes of MINOCA have been excluded. Methods and results: We prospectively evaluated patients with a diagnosis of MINOCA, excluding patients with aetiologies other than suspected coronary vasomotor abnormalities...
December 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29227870/impact-of-alcohol-drinking-on-acetylcholine-induced-coronary-artery-spasm-in-korean-populations
#13
Sung Min Sohn, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Seung-Woon Rha
BACKGROUND AND AIMS: Generally, immoderate alcohol consumption is associated with variant angina and accepted as one of the risk factors for coronary artery spasm (CAS), but evidence is lacking in this regard. The aim of this study is to evaluate the impact of alcohol consumption and drinking pattern on CAS by acetylcholine (ACH) provocation test and long-term clinical outcomes. METHODS: A total of 5491 patients with typical or atypical chest pain, without significant coronary artery disease, who underwent intracoronary ACH provocation test, were enrolled prospectively, and retrospectively analyzed in this study...
December 8, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29226572/nitroglycerin-and-the-enduring-principles-of-coronary-procedures
#14
EDITORIAL
On Topaz
The benefits of nitroglycerin are numerous, from ensuring accurate interpretation of diagnostic angiograms to treatment of coronary spasm and support of PCIs in simple or complex lesion types. The founders of the field were convinced that no coronary arteriography should be considered complete unless a vasodilator is used at some point during the study. This recommendation is valid. The guidelines should change to include administration of intracoronary nitroglycerin.
December 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29207372/catheter-induced-coronary-spasm-serious-but-preventable
#15
Farshad Forouzandeh, Alexander V Smolensky
While catheter-induced spasm is considered to be rare, it needs to be ruled out (especially in cases of left main stenosis) to avoid unnecessary revascularization. We present a patient where the underlying tendency for coronary spasm was so high, the severe spasm was possibly the underlying cause of a prior cardiac arrest episode.
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29176378/clinical-characteristics-and-outcomes-of-patients-with-coronary-artery-spasm-who-initially-presented-with-acute-myocardial-infarction
#16
Ji Bak Kim, Byoung Geol Choi, Seung-Woon Rha, Hong Seog Seo, Se Yeon Choi, Jae Kyeong Byun, Jin Oh Na, Cheol Ung Choi, Eung Ju Kim, Chang Gyu Park, Dong Joo Oh
BACKGROUND: The long-term clinical outcomes of coronary artery spasm (CAS) patients presented with acute myocardial infarction (AMI) compared to those who did not present with AMI has rarely been investigated. METHODS: From November 2004 to May 2014, a total of 3360 patients who were confirmed as CAS by the acetylcholine (Ach) provocation test and without significant coronary lesion were retrospectively analyzed. AMI was an initial presentation in 34 patients [CAS-myocardial infarction (MI) group], and not in other 3326 patients (CAS group)...
November 24, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29166637/assessing-vessel-tone-during-coronary-artery-spasm-by-dual-acquisition-multidetector-computed-tomography-angiography
#17
Cai De Jin, Moo Hyun Kim, Eun Ju Kang, Young Rak Cho, Tae Ho Park, Ki Nam Lee, Victor Serebruany
BACKGROUND: Diminished vascular tone is an established biomarker of heart damage. Little is known about the extent of coronary vessel tone (CVT) with spasm as assessed by dual-acquisition multidetector computed tomography angiography (MCTA) in patients with vasospastic angina (VSA). OBJECTIVE: We evaluated the CVT modulated by intravenous nitrate injection (INI) using MCTA imaging in VSA patients. METHODS: Twenty-one VSA patients (60 ± 9 years; 76% males) who underwent initial MCTA (without morning vasodilation), followed by an intracoronary ergonovine provocation test were included...
November 23, 2017: Cardiology
https://www.readbyqxmd.com/read/29165549/prognostic-impacts-of-rho-kinase-activity-in-circulating-leucocytes-in-patients-with-vasospastic-angina
#18
Taro Nihei, Jun Takahashi, Kiyotaka Hao, Yoku Kikuchi, Yuji Odaka, Ryuji Tsuburaya, Kensuke Nishimiya, Yasuharu Matsumoto, Kenta Ito, Satoshi Miyata, Yasuhiko Sakata, Hiroaki Shimokawa
Aims: Rho-kinase activity in circulating leucocytes is a useful biomarker for diagnosis and disease activity assessment of vasospastic angina (VSA). The present study aimed to examine the long-term prognostic impact of Rho-kinase activity in circulating leucocytes in VSA patients. Methods and results: We prospectively enrolled 174 consecutive patients with VSA and 50 non-VSA patients, in whom we measured Rho-kinase activity in circulating leucocytes, and they were followed for a median of 16 months...
November 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29164559/effects-of-carvedilol-on-vascular-reactivity-in-human-left-internal-mammary-artery
#19
M Guzeloglu, E Ertuna, M Z Arun, B Reel
OBJECTIVE: Surgical treatment choice for coronary artery disease is coronary artery bypass grafting (CABG) surgery. Left internal mammary artery (LIMA) is frequently used as an arterial graft in CABG operations. Perioperative spasm of LIMA can result in increased morbidity and mortality. Pharmacological interventions are routinely used for prevention and treatment of LIMA spasm. In this study, we aimed to investigate the effects of carvedilol, an alpha- and beta-adrenergic receptor blocker, on responses to endogenous vasoconstrictors which play a role in graft spasm and the possible interaction between carvedilol and diltiazem/papaverine which are vasodilators commonly used in CABG surgery...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29147480/a-rare-case-of-late-onset-saphenous-vein-graft-spasm
#20
Nirmal Guragai, Upamanyu Rampal, Rahul Vasudev, Hiten Patel, Meherwan B Joshi, Fayez Shamoon
Spasm following coronary artery bypass graft surgery has been well established in arterial grafts, especially in grafts utilizing the internal mammary. Venous graft spasms are uncommon and are only observed in vein grafts during or soon after the coronary artery bypass surgery. It is exceedingly rare to see spasm of venous graft beyond one year of surgery. We report a 72-year-old female who had coronary artery bypass graft three years ago and presented with new onset chest pain for one month. The coronary angiogram revealed severe spasm of the proximal aspect of a patent saphenous venous graft which was relieved by intracoronary nitroglycerine...
2017: Journal of Community Hospital Internal Medicine Perspectives
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