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Coronary Spasm

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https://www.readbyqxmd.com/read/29147480/a-rare-case-of-late-onset-saphenous-vein-graft-spasm
#1
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
https://www.readbyqxmd.com/read/29143297/impact-of-trimetazidine-treatment-on-5-year-clinical-outcomes-in-patients-with-significant-coronary-artery-spasm-a-propensity-score-matching-study
#2
Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, 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
OBJECTIVE: We aimed to evaluate the additive benefit of trimetazidine with well-known antispasmodic agents such as calcium channel blockers and nitrate in patients with significant coronary artery spasm (CAS) as assessed by acetylcholine provocation test up to 5 years. METHODS: A total 1727 patients with significant CAS were enrolled. They were divided into two groups: a trimetazidine group (trimetazidine, diltiazem, and nitrate, n = 695), and control group (diltiazem and nitrate, n = 473)...
November 15, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29131513/role-of-vascular-ultrasound-scanning-in-repeated-trans-radial-coronary-artery-intervention-prospective-randomized-study
#3
Mahmoud Farouk Elmahdy, Mohamed Hassan, Ahmed Elguindy
OBJECTIVES: We aimed to detect if pre-procedure vascular ultrasound scanning (VUS) of radial arteries (RAs) can increase the radial access success (RAS) rate and/or reduce the vascular access time (VAT), by guiding the choice of the proper access site for repeated trans-radial interventions (TRIs). BACKGROUND: Currently, repeated-TRIs are encountered more frequently in most of the cath. labs. However, structural changes of the RAs after TRA may hinder it is usage for repeated-TRI...
November 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29121758/tpeak-tend-dispersion-as-a-predictor-for-malignant-arrhythmia-events-in-patients-with-vasospastic-angina
#4
Wang Xianpei, Wu Sha, Gao Chuanyu, Yan Juanjuan, Chen Chong, Shi Yongen, Feng Yu, Lin Zhenhao
BACKGROUND: Tpeak-Tend interval (Tp-e interval) in electrocardiogram (ECG) has been reported to predict malignant arrhythmia events (MAE) in ST-segment elevation myocardial infarction and ion channelopathy. Tp-e interval and other ECG parameters as predictors for MAE was evaluated in patients with vasospastic angina (VA). METHODS AND RESULTS: Sixty-two patients with VA (Non-MAE group) and 20 patients with VA complicated by MAE (MAE group) were enrolled in our Division of Cardiology between January 2010 and December 2015...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29113865/identifying-strategy-for-ad-hoc-percutaneous-coronary-intervention-in-patients-with-anticipated-unfavorable-radial-access-the-little-women-study
#5
Gregory A Sgueglia, Daniel Todaro, Antonella De Santis, Micaela Conte, Gaetano Gioffrè, Angela Di Giorgio, Fabrizio D'Errico, Fabiana Piccioni, Francesco Summaria, Achille Gaspardone
BACKGROUND: Transradial percutaneous coronary intervention (PCI) offers important advantages over transfemoral PCI, including better outcomes. However, when there is indication to ad hoc PCI, a 6 French workflow is a common default strategy, hence potentially influencing vascular access selection in patients with anticipated small size radial artery. METHODS: A multidimensional evaluation was performed to compare two ad hoc interventional strategies in women <160cm: a full 6 French workflow (namely 6 French introducer sheath, diagnostic catheters and guiding catheter) with a modified workflow consisting in the use of 5 French diagnostic catheters preceded by the placement of a 6 French sheath introducer and followed by a 6 French guiding catheter use for PCI...
October 16, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29109645/neostigmine-induced-coronary-artery-spasm-a-case-report-and-literature-review
#6
Shimon Kolker, Dan Tzivoni, David Rosenmann, Shmuel Meyler, Alexander Ioscovich
Neostigmine is a cholinesterase inhibitor which does not cross the blood brain barrier and a commonly used for reversal of nondepolarizing muscle relaxants. In the following case report, we present a patient who developed coronary artery spasm, after the administration of repeated doses of neostigmine. Ours is the first case to demonstrate such a longstanding coronary artery vasospasm that lasted several hours in response to neostigmine, resulting in myocardial damage and left ventricular dysfunction. We would like to draw the attention of the anesthesiologists to this rare effect that may lead to perioperative cardiac complications...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29107024/relaxant-effect-of-the-prostacyclin-analogue-iloprost-on-isolated-human-radial-artery-an-approach-for-the-reversal-of-graft-spasm
#7
Ersoy Engin, F İlkay Alp Yildirim, Deniz Kalelі Durman, Suat Nail Ömeroğlu, Deniz Göksedef, Önder Teskіn, Ozan Onur Balkanay, Gökhan İpek, B Sönmez Uydeş Doğan
Radial artery graft spasm in the perioperative or postoperative period of coronary bypass surgery necessitates urgent treatment due to risk of graft failure and mortality. Herein, we evaluated the effect of iloprost, a prostacyclin (PGI2) analogue, against the contractions produced by noradrenaline and potassium chloride on isolated human radial artery. Following the determination of endothelial and vascular relaxing capacities of the arteries, iloprost (10(-9)M-10(-6)M) was cumulatively applied on rings precontracted submaximally with the spasmogens...
October 26, 2017: Prostaglandins & Other Lipid Mediators
https://www.readbyqxmd.com/read/29106829/-sudden-cardiac-death-and-coronary-thrombus
#8
C Spaulding, N Karam
Out-of-hospital cardiac arrest is most often due to an acute coronary artery occlusion. The cause of coronary thrombosis in cardiac arrest is debated. Plaque erosion could be a trigger leading to immediate thrombus formation followed by ventricular fibrillation or rapid ventricular tachycardia. Coronary artery spasm is frequent: spasm provocation tests should be performed in survivors with normal coronary arteries. Use of drugs such as cocaine can lead to sudden death and blood sampling at arrival is recommended in survivors of out-of-hospital cardiac arrest...
October 26, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29096905/-involvement-of-thrombophilia-in-coronary-thrombosis
#9
C Bal Dit Sollier, L Drouet
This review of thrombophilia and coronary thrombosis takes into account the "classical" thrombophilia commonly found in venous pathology and the conditions under which their research may be useful in certain forms of arterial thrombosis especially coronary thrombosis. In addition to the classical thrombophilia, exceptional thrombophilia are evoked, which are both factors of venous thrombosis but also arterial thrombosis. There are also thrombophilia that are more specific to the arterial system such as - homocystein which is potentially both a thrombosis factor but also an agent of arterial parietal lesion or - serotonin which is a factor of arterial spasm and especially coronary spasm...
October 30, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29096805/sex-related-differences-in-vasomotor-function-in-patients-with-angina-and%C3%A2-unobstructed-coronary-arteries
#10
Ahmed Aziz, Henrik Steen Hansen, Udo Sechtem, Eva Prescott, Peter Ong
BACKGROUND: Coronary vasomotor dysfunction is an important mechanism for angina in patients with unobstructed coronary arteries. OBJECTIVES: The purpose of this study was to determine sex differences in the prevalence and clinical presentation of vasomotor dysfunction in a European population and to examine sex differences in the dose of acetylcholine leading to a positive acetylcholine provocation test (ACH test). METHODS: Between 2007 and 2014, we included 1,379 consecutive patients with stable angina, unobstructed coronaries and ACH test performed for epicardial vasospasm or coronary microvascular dysfunction (CMD) due to microvascular spasm...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29093410/coronary-artery-spasm-during-cryoballoon-ablation-in-a-patient-with-atrial-fibrillation
#11
Kazuhiro Yajima, Yuichiro Yamase, Hideo Oishi, Noriyuki Ikehara, Yasushi Asai
The patient was a 63-year-old man with drug-resistant atrial fibrillation who developed coronary spasm during cryoballoon ablation (CBA). CBA was started from the left inferior pulmonary vein. ST elevations in II, III, and aVf, with reciprocal ST depressions in V2-5, occurred in association with chest pain just after balloon rewarming and deflation, and the patient's blood pressure fell to 50 mmHg. Coronary angiography revealed 90% diffuse stenosis from the orifice of segment 1 to segment 4 in the right coronary artery...
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29090269/a-rash-decision-the-hazards-of-the-wrongful-use-of-adrenaline
#12
Madalena Coutinho Cruz, Ramiro Sá Carvalho, Pedro Modas Daniel, Rui Cruz Ferreira
Anaphylaxis is life-threatening and should be addressed urgently. Its treatment is not without side effects and an accurate diagnosis must be made to prevent potential harm by the wrongful use of medication. A 46-year-old woman with hypertension treated with angiotensin converting enzyme inhibitor (ACEI) presented to the emergency department with non-pitting oedema of the face and limbs. A hasty diagnosis of anaphylaxis was made and intravenous adrenaline administered. The patient developed a myocardial infarction caused by coronary artery spasm that required invasive intervention...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29084192/transient-left-ventricular-dysfunction-due-to-coronary-spasm-after-spinal-anesthesia-with-bupivacaine-a-case-report
#13
Waldemar Elikowski, Małgorzata Małek-Elikowska, Marek Słomczyński, Karolina Horbacka, Jarosław Bartkowski, Bartosz Kalawski
Bupivacaine is a long-acting local anesthetic (LA) used for cutaneous infiltration, peripheral nerve blocks, epidural and spinal anesthesia. However, its application may result in cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. The authors describe a 53-year-old male with a history of cigarette smoking, admitted for an elective inguinal hernia surgery. Before surgery, the patient received subarachnoid injection of bupivacaine (20 mg). After the operation, he developed transient hypotension...
October 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29079038/the-role-of-endothelial-nitric-oxide-synthase-786%C3%A2-t-c-polymorphism-in-cardiac-instability-following-aneurysmal-subarachnoid-hemorrhage
#14
Philipp Hendrix, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
INTRODUCTION: Cardiac abnormalities are observed frequently after aneurysmal subarachnoid hemorrhage (aSAH). A subset of aSAH patients develops neurogenic cardiomyopathy, likely induced by catecholamine excess. Genetic polymorphisms of the endothelial nitric oxide synthase (eNOS) gene have been linked to decreased nitric oxide (NO) levels, coronary artery spasm, and myocardial infarction. The role of the eNOS single nucleotide polymorphism (SNP) -786 T/C in cardiac instability following aSAH has not been previously investigated...
October 24, 2017: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/29064536/flow-mediated-dilatation-to-relieve-puncture-induced-radial-artery-spasm-a-pilot-study
#15
Lianghong Ying, Ke Xu, Xiaoxuan Gong, Xiaoyan Liu, Yuansheng Fan, Haiping Zhao, Fei Wang, Mohammad Reeaze Khurwolah, Chunjian Li
BACKGROUND: Puncture-induced radial artery spasm (RAS) may extend the duration of coronary angiography (CAG) or cause transradial access failure. Flow-mediated dilatation (FMD), a widely-used noninvasive approach for assessing endothelial function, was reported to remove the entrapped radial sheath after percutaneous coronary intervention. Herein, the efficacy and safety of FMD in treating puncture-induced RAS before transradial CAG was investigated. METHODS: Ninety patients with puncture-induced RAS were randomized in a 1:1:1 ratio into three groups: FMD group was immediately treated with blockage of brachial artery blood for 5 min using a sphygmomanometric cuff and then rapid relief; NTG group was administered with 0...
October 24, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/29061547/randomized-comparison-of-judkins-vs-tiger-catheter-in-coronary-angiography-via-the-right-radial-artery-the-judge-study
#16
Ioanna Xanthopoulou, Katerina Stavrou, Periklis Davlouros, Grigorios Tsigkas, Eleni Koufou, Georgios Almpanis, Michalis Koutouzis, Ioannis Tsiafoutis, Angelos Perperis, Athanasios Moulias, Nikolaos Koutsogiannis, George Hahalis
AIMS: To compare the performance of Tiger-II compared with Judkins 3.5L/4R catheters in coronary angiography (CAG) via the transradial approach (TRA). METHODS AND RESULTS: Consecutive patients undergoing non-urgent CAG via the right TRA were randomized to either Tiger-II (Terumo) or Judkins (3.5L/4R, Medtronic) 5Fr catheters and 320 patients in each group were randomized. Catheter or access site change was required in 57(17.8%) vs 68(21.3%) patients allocated in the Tiger-II and Judkins group respectively (p=0...
October 24, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29059651/-the-features-of-a-functional-state-of-the-coronary-circulation-in-women-smokers-with-non-st-elevation-acute-coronary-syndrome
#17
Тетяна М Соломенчук, Артем О Бедзай, Василь В Процько
INTRODUCTION: Acute coronary syndrome is one of the most adverse prognostic clinical forms of ischemic heart disease. In recent years, attention of researchers and cardiologists practical attract female patients due to a substantial increase in the prevalence including acute coronary syndrome, differences in the causes and features of its course. Women often diagnosed myocardial infarction without ST elevation and nonobstructive coronary heart disease associated with coronary spasm or stratification of coronary artery...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29031990/international-standardization-of-diagnostic-criteria-for-microvascular-angina
#18
Peter Ong, Paolo G Camici, John F Beltrame, Filippo Crea, Hiroaki Shimokawa, Udo Sechtem, Juan Carlos Kaski, C Noel Bairey Merz
Standardization of diagnostic criteria for ischemic symptoms due to coronary microvascular dysfunction (CMD) is needed for further investigation of patients presenting with anginal chest pain consistent with "microvascular angina" (MVA). At the annual Coronary Vasomotion Disorders International Study Group (COVADIS) Summits held in August 2014 and 2015, the following criteria were agreed upon for the investigative diagnosis of microvascular angina: (1) presence of symptoms suggestive of myocardial ischemia; (2) objective documentation of myocardial ischemia, as assessed by currently available techniques; (3) absence of obstructive CAD (<50% coronary diameter reduction and/or fractional flow reserve (FFR) >0...
September 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29030424/stable-coronary-syndromes-pathophysiology-diagnostic-advances-and-therapeutic-need
#19
REVIEW
Thomas J Ford, David Corcoran, Colin Berry
The diagnostic management of patients with angina pectoris typically centres on the detection of obstructive epicardial CAD, which aligns with evidence-based treatment options that include medical therapy and myocardial revascularisation. This clinical paradigm fails to account for the considerable proportion (approximately one-third) of patients with angina in whom obstructive CAD is excluded. This common scenario presents a diagnostic conundrum whereby angina occurs but there is no obstructive CAD (ischaemia and no obstructive coronary artery disease-INOCA)...
October 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29030064/five-year-major-clinical-outcomes-according-to-severity-of-coronary-artery-spasm-as-assessed-by-intracoronary-acetylcholine-provocation-test
#20
Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, Byoung Geol Choi, Minsuk Shim, Se Yeon Choi, Jae Kyeong Byun, Hu Li, Woohyeun Kim, Jun Hyuk Kang, Jah Yeon Choi, Eun Jin Park, Sung Hun Park, Sunki Lee, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh
BACKGROUND: Long-term clinical outcome data according to severity of coronary artery spasm (CAS) as assessed by an intracoronary acetylcholine provocation test are limited in series of Asian patients. AIM: To investigate 5-year clinical outcomes in patients with CAS according to CAS severity. METHODS: In total, 5873 consecutive patients with insignificant coronary artery disease (<70% fixed stenosis) who underwent an acetylcholine provocation test were enrolled and divided into four groups according to CAS severity during the acetylcholine provocation test: negative, borderline positive, moderately positive and severely positive...
October 10, 2017: Archives of Cardiovascular Diseases
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