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Coronary Spasm

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https://www.readbyqxmd.com/read/28319321/unrecognized-coronary-vasospasm-in-patients-referred-for-percutaneous-coronary-intervention-intracoronary-nitroglycerin-the-forgotten-stepchild-of-cardiovascular-guidelines
#1
Alec Vishnevsky, Howard M Julien, David L Fischman, Paul Walinsky, J David Ogilby, Nicholas J Ruggiero, Babu Jasti, Michael P Savage
OBJECTIVE: The goal of this study was to demonstrate the importance of intracoronary nitroglycerin (IC NTG) administration during diagnostic coronary angiography and prior to percutaneous coronary intervention (PCI). BACKGROUND: PCI has been a mainstay treatment for patients with symptomatic coronary artery disease. While current guidelines emphasize the importance of periprocedural antithrombotic medications, they fail to mention the use of nitroglycerin prior to PCI...
March 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28303667/exercise-induced-saphenous-vein-graft-spasm-prevented-by-stenting
#2
William G Boliek, Dean J Kereiakes, Atul Chugh
Recurrence of anginal symptoms following coronary artery bypass surgery is usually secondary to graft closure or progression of native vessel disease. The present case demonstrates severe exercise-induced saphenous vein graft (SVG) spasm associated with transmural ischemia refractory to maximal vasodilator therapy. Symptoms resolved and exercise electrocardiography normalized following stenting of SVG regions demonstrating spasm. © 2017 Wiley Periodicals, Inc.
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28283339/prinzmetal-angina-coronary-vasospasm-associated-with-5-fluorouracil-chemotherapy
#3
Maxim Ben-Yakov, Amal Mattu, William J Brady, Sarah B Dubbs
Several chemotherapeutic agents are known to be cardiotoxic. One of them, 5-fluorouracil (5-FU), has been associated with coronary ischemia and reversible vasospasm. In this report, we describe a 54-year-old man with rectal cancer who developed chest pain during 5-FU infusion. His initial electrocardiogram (ECG), obtained while he was experiencing chest pain, showed hyperacute T waves in the anterolateral leads. Those waves disappeared along with the chest pain after administration of sublingual nitroglycerine...
March 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28273995/prinzmetals-angina-masquerading-as-acute-pericarditis
#4
Ashwal Adamane Jayaram, Mugula Sudhakar Rao, R Padmakumar, Uk Abdul Razak
Coronary artery spasm is an intense vasoconstriction of the coronary arteries and may be responsible for the myocardial ischemia, myocardial infarction as well as sudden deaths. Coronary angiography is generally needed to identify the cause. Coronary artery spasm is a multifactorial disease with underlying mechanism still poorly understood. Here, we present case of a 48-year-old male with no significant past history who presented with acute episodic onset chest pain. Clinical, Electrocardiography (ECG) and echocardiographic findings suggested pericarditis but a diagnostic coronary angiography revealed significant coronary vasospasm...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28268085/ultra-long-acting-calcium-channel-blockers-may-decrease-accuracy-of-the-acetylcholine-provocation-test
#5
Manabu Kurabayashi, Mitsutoshi Asano, Tsukasa Shimura, Hidetoshi Suzuki, Hideshi Aoyagi, Yasuteru Yamauchi, Kaoru Okishige, Takashi Ashikaga, Mitsuaki Isobe
BACKGROUND: When drug-induced coronary spasm provocation tests are performed, a washout period of >48h for calcium channel blockers (CCBs) is uniformly recommended. However, each CCB has a distinct half-life, and little is known about the influence of prior oral administration of CCBs on acetylcholine provocation test to evaluate coronary vasomotor reaction. METHODS AND RESULTS: We examined 245 consecutive patients with suspected vasospastic angina who had undergone acetylcholine provocation test...
February 28, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28242292/systemic-mastocytosis-kounis-syndrome-and-coronary-intervention-case-report-and-systematic-review
#6
REVIEW
Elizabeth D Paratz, Nancy Khav, Andrew T Burns
A 72-year-old male reported a long-standing history of unexplained syncope. Stress echocardiography demonstrated inducible anterior hypokinesis, and he proceeded to percutaneous coronary intervention for an 80% stenosis of the left anterior descending artery. Thirty minutes post-procedure, he experienced a pulseless electrical activity (PEA) cardiac arrest. Urgent repeat angiography demonstrated profound coronary artery spasm consistent with Kounis syndrome. Three days later, a second PEA arrest occurred. Systemic mastocytosis was ultimately diagnosed as the cause of his recurrent syncopal episodes and cardiac arrests...
February 15, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28218605/comparison-of-a-new-slender-6-french-sheath-with-a-standard-5-french-sheath-for-transradial-coronary-angiography-and-intervention-a-randomized-multicenter-trial-the-rap-and-beat-radial-artery-patency-and-bleeding-efficacy-adverse-event-trial
#7
Adel Aminian, Shigeru Saito, Akihiko Takahashi, Ivo Bernat, Robert Lee Jobe, Takashi Kajiya, Ian C Gilchrist, Yves Louvard, Ferdinand Kiemeneij, Niels Van Royen, Seiji Yamazaki, Takashi Matsukage, Sunil V Rao
AIMS: The 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) is a recently developed thin-walled radial sheath with an outer diameter (OD) that is smaller than the OD of standard 6Fr sheaths. The effect of this introducer sheath on radial artery occlusion (RAO) is unknown. METHODS AND RESULTS: We conducted a randomized, multicenter, non-inferiority trial comparing the GSS6Fr against the standard 5Fr Glidesheath (GS5Fr, Terumo, Japan) in patients undergoing TR coronary angiography and/or intervention...
February 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28207539/role-of-coronary-angiography-for-out-of-hospital-cardiac-arrest-survivors-according-to-postreturn-of-spontaneous-circulation-on-an-electrocardiogram
#8
Tae Rim Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors.We collected data from our OHCA registry from January 2010 to November 2014...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28150279/can-radial-artery-pulse-grading-predict-radial-artery-spasm-during-transradial-approach
#9
Ertuğrul Zencirci, Aleks Değirmencioğlu
BACKGROUND AND AIM: Radial artery spasm (RAS) has been defined as the one of the major disadvantage of transradial approach. The aim of this study was to investigate the predictive value of radial artery pulse grading on RAS during transradial approach. METHODS: The present study prospectively included 115 consecutive patients who underwent transradial coronary catheterization at a single center. Patients were divided into two groups: those with RAS and those without...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28142134/coronary-spasm-after-an-injection-of-vincristine
#10
Rosine Gros, Vincent Hugon, Jean-Marc Thouret, Vincent Peigne
Cardiotoxicity, including heart failure, thromboembolic events, and myocardial ischemia, is a concern for cardiologists and oncologists. The most frequently involved drugs are anthracyclines. We report an episode of coronary spasm due to vincristine, a vinca alkaloid, in a 49-year-old man treated for a diffuse undifferentiated carcinoma. The patient suffered recurrent episodes of typical chest pain with ST-elevation in the inferior area. Coronary spasm was confirmed by an angiogram, which showed normal coronary arteries...
February 1, 2017: Chemotherapy
https://www.readbyqxmd.com/read/28139456/primary-angioplasty-effect-of-deferred-stenting-on-stent-size
#11
Brahim Harbaoui, Philippe Emsellem, Emmanuel Cassar, Cyril Besnard, Raphael Dauphin, Pascal Motreff, Pierre-Yves Courand, Pierre Lantelme
BACKGROUND: Primary angioplasty with immediate stenting (IS) is the gold standard for ST-segment elevation myocardial infarction (STEMI). Deferred stenting (DS) has been proposed to limit periprocedural complications, and may influence stent size because of thrombus and spasm alleviation. AIM: We sought to study the effect of DS on stent size. METHODS: Over the study period, 258 patients underwent primary angioplasty for STEMI (DS, n=84; IS, n=174)...
January 27, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28110808/suppression-of-graft-spasm-by-the-particulate-guanylyl-cyclase-activator-in-coronary-bypass-surgery
#12
Takeshi Kinoshita, Masashi Tawa, Tomoaki Suzuki, Yoshinari Aimi, Tohru Asai, Tomio Okamura
BACKGROUND: Spasm of arterial grafts is still a clinical problem in coronary artery bypass surgery. The present study was designed to examine the effect of particulate guanylyl cyclase activator (carperitide) as an antispastic agent in internal thoracic artery and gastroepiploic artery grafts. METHODS: Isolated arterial grafts taken during surgery were studied in organ bath in three ways: the relaxing effect of carperitide on vasoconstrictor-induced precontraction; the inhibitory effect of pretreatment with carperitide on subsequent vasoconstrictor-induced contraction; and the effect of carperitide and nitroglycerin on increase of intracellular cyclic guanosine monophosphate levels...
January 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28107550/enhanced-trpc-channel-mediated-ca-2-influx-in-the-cells-with-phospholipase-c-%C3%AE-1-overexpression-its-possible-role-in-coronary-artery-spasm
#13
Kazuo Murakami, Tomohiro Osanai, Makoto Tanaka, Kimitaka Nishizaki, Takahiko Kinjo, Tomohiro Tanno, Yuji Ishida, Akiko Suzuki, Tomohide Endo, Hirofumi Tomita, Ken Okumura
We reported that coronary spasm was induced in the transgenic mice with the increased phospholipase C (PLC)-δ1 activity. We investigated the effect of enhanced PLC-δ1 on Ca(2+) influx and its underlying mechanisms. We used human embryonic kidney (HEK)-293 and coronary arteries-smooth-muscle cells (CASMC). Intracellular free Ca(2+) concentration ([Ca(2+) ]i ) (nM) was measured by fura-2, and Ca(2+) influx was evaluated by the increase in [Ca(2+) ]i after addition of extracellular Ca(2+) . Acetylcholine (ACh) was used to induce Ca(2+) influx...
January 20, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28100348/-right-coronary-artery-spasm-induced-acute-inferior-wall-myocardial-infarction-complicating-electrical-storm-a-case-report
#14
J Liang, Y J Zhou, H Y Han
No abstract text is available yet for this article.
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28096836/coronary-artery-spasm-following-on-pump-coronary-artery-bypass-grafting-with-20-months-follow-up
#15
Adam R Kowalówka, Marcin Malinowski, Magdalena Onyszczuk, Marek Deja
We report on a 69-year-old woman who demonstrated native coronary artery and grafted vessel spasm following on-pump coronary artery bypass grafting (CABG). Despite intraaortic balloon pump (IABP) insertion, electrocardiogram (ECG) abnormalities did not disappear. Emergency coronary angiography (CAG) was performed. The patient was successfully treated with systemic and intracoronary injection of vasodilator agents. ECG changes disappeared, with normalized and stable hemodynamic function. Intraaortic balloon pump was maintained for 48 h...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28092292/epicardial-collaterals-spasm-as-a-cause-of-st-elevation-myocardial-infarction
#16
Vincenzo Vetrugno, Francesco Fracassi, Osama Shoeib, Domenico D'Amario, Giampaolo Niccoli, Filippo Crea
ST elevation myocardial infarction in a 61-year-old man with a history of previous coronary artery bypass grafts. Spasm of collaterals to the circumflex coronary artery was the cause of acute presentation and was successfully treated by intracoronary nitrates. Chronic therapy with calcium channel blockers was added in the discharge medications chart.
January 13, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28087177/lymphocytic-myocarditis-occurs-with-myocardial-infarction-and-coincides-with-increased-inflammation-hemorrhage-and-instability-in-coronary-artery-atherosclerotic-plaques
#17
Linde Woudstra, P Stefan Biesbroek, Reindert W Emmens, Stephane Heymans, Lynda J Juffermans, Albert C van Rossum, Hans W M Niessen, Paul A J Krijnen
OBJECTIVE: Although lymphocytic myocarditis (LM) clinically can mimic myocardial infarction (MI), they are regarded as distinct clinical entities. However, we observed a high prevalence (32%) of recent MI in patients diagnosed post-mortem with LM. To investigate if LM changes coronary atherosclerotic plaque, we analyzed in autopsied hearts the inflammatory infiltrate and stability in coronary atherosclerotic lesions in patients with LM and/or MI. METHODS: The three main coronary arteries were isolated at autopsy of patients with LM, with MI of 3-6h old, with LM and MI of 3-6h old (LM+MI) and controls...
April 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28031683/left-main-coronary-spasm-an-extremely-rare-entity-with-possible-life-threatening-complications
#18
A Al Emam, N Sricharoen
Coronary artery spasm is a known cause of acute coronary syndrome. However, left main coronary spasm is an extremely rare entity and can present in different ways depending on the duration and severity of the spasm. We present a 44-year-old female patient who presented with transient ST elevation in the lead aVR and ST depression in the lateral and inferior leads. Coronary angiography showed mid left main and ostial right coronary artery spasm that significantly improved after intracoronary nitroglycerine administration...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28017336/spasm-and-reopening-of-the-right-gastroepiploic-artery-conduit-after-coronary-artery-bypass-grafting
#19
Jae-Hak Huh, Kyung-Hak Lee, Kwang Ree Cho, Ho Young Hwang, Ki-Bong Kim
BACKGROUND: The right gastroepiploic artery (RGEA) has advantages for use as an arterial conduit in coronary artery bypass graft surgery but perioperative spasm often develops. This study assessed the spasm and occlusion rates of RGEA conduits and elucidated the mechanism of reopening of occluded RGEA conduits. METHODS: Patients who received an RGEA conduit in coronary artery bypass graft surgery were studied (n = 976; 700 composite, 276 in situ, 16 free grafts; 16 received both in situ and composite grafts)...
December 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28012648/impact-of-vasomotion-type-on-prognosis-of-coronary-artery-spasm-induced-by-acetylcholine-provocation-test-of-left-coronary-artery
#20
Eun Mi Lee, Man Ho Choi, Hong Seog Seo, Hyun Ki Kim, Nam-Ho Kim, Cheol Ung Choi, Jin Won Kim, Hong Euy Lim, Eung Ju Kim, Seung-Woon Rha, Chang Gyu Park, Dong Joo Oh
BACKGROUND AND AIMS: The impact of vasomotion types on long-term clinical outcomes in patients with coronary artery spasm (CAS) induced by the acetylcholine provocation test (ACH-test) remains unclear. METHODS: We evaluated 4644 consecutive patients with typical resting chest pain (CP), but no angiographically significant coronary artery lesion (<50% stenosis), who underwent an ACH-test. According to their vasomotor response, patients were categorized into four types: normal vasomotion (no CP, no ischemic electrocardiographic changes, and no vasoconstriction), microvascular spasm (CP with <75% vasoconstriction but with CP relief after nitroglycerin infusion), epicardial spasm (CP with ≥75% vasoconstriction), and ACH-test inconclusive (vasoconstriction and/or electrocardiographic changes, but no CP)...
February 2017: Atherosclerosis
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