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https://www.readbyqxmd.com/read/28819899/significance-of-intravascular-ultrasound-and-exercise-stress-echocardiography-in-diagnosis-of-exercise-induced-vasospastic-angina-at-the-site-of-moderate-stenosis
#1
Makio Muraishi, Kentaro Shibayama, Masahiko Noguchi, Hiroyuki Watanabe, Kotaro Obunai
Recently, exercise-induced spastic coronary artery occlusion at the site of moderate stenosis, which Prinzmetal's angina or cardiac syndrome X does not cover, was reported. Multi-modality imaging is important for the diagnosis of coronary artery disease with a complex ischemic mechanism. However, the previous report did not include findings from intracoronary imaging at the site of moderate coronary stenosis. We report a case of exercise-induced vasospastic angina at the site of moderate stenosis, where multi-modality imaging, including exercise stress echocardiography and intravascular ultrasound, was utilized to make a definitive diagnosis and investigate underlying causes...
August 17, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/28801137/the-challenges-of-treating-recurrent-polymorphic-ventricular-tachycardia-due-to-coronary-vasospasm-lessons-from-an-interesting-case
#2
Naveen Trehan, Mobeen Ur Rehman, Anupama Kottam
Coronary artery vasospasm can cause recurrent anginal episodes with ST-segment elevation. Vasospasm induced myocardial ischemia can lead to arrhythmias including life threatening ventricular tachycardia (VT). Percutaneous coronary intervention (PCI), although not routinely recommended for treating vasospastic angina, can be considered for discrete coronary spasm that is not amenable to vasodilator therapy. We present a challenging case of a 41-year-old lady with recurrent episodes of vasospastic angina and VT refractory to medical therapy, which was successfully treated with PCI and an implantable cardioverter defibrillator...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28781824/effectiveness-of-continuous-low-dose-fasudil-on-refractory-coronary-vasospasm-subsequent-to-cardiopulmonary-arrest
#3
Daisuke Ooshiro, Satoshi Yamaguchi, Masanori Kakazu, Osamu Arasaki
Refractory coronary vasospasm subsequent to reperfusion, such as cardiopulmonary resuscitation or revascularization, for myocardial infarction may respond to fasudil in the superacute phase. Continuous low-dose fasudil administration should be an option for refractory coronary vasospastic angina (VSA).
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28730843/clinical-value-of-st-segment-change-after-return-of-spontaneous-cardiac-arrest-and-emergent-coronary-angiography-in-patients-with-out-of-hospital-cardiac-arrest-diagnostic-and-therapeutic-importance-of-vasospastic-angina
#4
Kazuya Tateishi, Daisuke Abe, Tooru Iwama, Yuichi Hamabe, Kazutaka Aonuma, Akira Sato
BACKGROUND: We investigated the association between initial ST-segment change after return of spontaneous circulation (ROSC) and the incidence of acute coronary lesions in patients with out-of-hospital cardiac arrest (OHCA), and clinical outcomes of patients with OHCA caused by vasospastic angina pectoris (VSA). METHODS: Among 2779 OHCA patients in our institution, all patients with ROSC underwent emergent coronary angiography (CAG) except for those with an obvious extra-cardiac cause of OHCA...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28725290/the-discovery-of-the-flammer-syndrome-a-historical-and-personal-perspective
#5
REVIEW
Josef Flammer, Katarzyna Konieczka
This review describes the clinical and basic research that led to the description of Flammer syndrome. It is narrated from a personal perspective. This research was initiated by the observation of an increased long-term fluctuation of visual fields in a subgroup of glaucoma patients. As these patients had strikingly cold hands, peripheral blood flow was tested with a capillary microscopy, and vasospastic syndrome (VS) was diagnosed. Further studies on these patients revealed frequently weakened autoregulation of ocular blood flow and increased flow resistivity in retroocular vessels...
June 2017: EPMA Journal
https://www.readbyqxmd.com/read/28699981/exuberant-vasospastic-angina-simulating-severe-three-vessel-disease
#6
Bruno Marmelo, Luís Abreu, Júlio Gil, Pedro Ferreira, José Cabral
No abstract text is available yet for this article.
June 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28665063/uric-acid-level-has-a-u-shaped-association-with-clinical-outcomes-in-patients-with-vasospastic-angina
#7
Hye Bin Gwag, Jeong Hoon Yang, Taek Kyu Park, Young Bin Song, Joo Yong Hahn, Jin Ho Choi, Sang Hoon Lee, Hyeon Cheol Gwon, Seung Hyuk Choi
No data are available on the association of serum uric acid and vasospastic angina (VSA) which has endothelial dysfunction as a possible pathophysiologic mechanism. Low uric acid level might cause adverse outcomes in VSA in connection with endothelial dysfunction. We enrolled 818 VSA patients whose uric acid level was measured at admission. Patients were categorized according to tertiles of uric acid level: group I, ≤ 4.8 mg/dL; group II, 4.9-5.9 mg/dL; and group III, ≥ 6.0 mg/dL. Primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, acute myocardial infarction (MI), ischemic stroke, coronary revascularization, and rehospitalization for angina...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28659551/impact-of-stent-type-and-presence-of-vasospastic-angina-on-long-term-prognosis
#8
Reo Hata, Naoki Oka, Shunsuke Kubo, Akimune Kuwayama, Masanobu Ohya, Takenobu Shimada, Katsuya Miura, Hidewo Amano, Yusuke Hyodo, Suguru Otsuru, Seiji Habara, Takeshi Tada, Hiroyuki Tanaka, Yasushi Fuku, Tsuyoshi Goto, Kazushige Kadota
BACKGROUND: Little is known about the impact of stent type on the prognosis of vasospastic angina (VSA) in patients who undergo stent implantation.Methods and Results:We evaluated consecutive patients undergoing coronary angiography with positive (n=650; VSA) and negative (n=2,872; non-VSA) ergonovine testing. Among them, 304 patients undergoing stent implantation for organic stenosis were classified for comparison into 3 respective VSA and non-VSA groups based on stent type (68 and 78 with bare-metal stent [BMS]; 21 and 49 with sirolimus-eluting stent [SES]; 26 and 62 with newer generation drug-eluting stent [N-DES])...
June 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28648167/-cardiac-arrest-induced-by-vasospastic-angina-pectoris-after-vaginally-administered-misoprostol
#9
Terese Matthesen, Rasmus Huan Olsen, Helle Skovmand Bosselmann, Øjvind Lidegaard
A 41-year-old woman developed cardiac arrest after administration of misoprostol in order to induce an abortion. She was successfully resuscitated. Coronary angiography revealed coronary artery spasm which responded to nitroglycerine. Misoprostol is first-line treatment for medically induced abortion. Reports have described cardiovascular adverse events in women with cardiovascular risk factors, and clinicians should be aware of this.
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28608267/renal-denervation-as-a%C3%A2-treatment-strategy-for-vasospastic-angina-induced-ventricular-tachycardia
#10
L Feyz, S Wijchers, J Daemen
No abstract text is available yet for this article.
June 12, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28607620/manifestation-of-j-wave-induced-by-acetylcholine-applied-for-a-coronary-spasm-provocation-test-in-a-patient-with-aborted-sudden-cardiac-death
#11
Hiroyuki Kodama, Kazumasa Fujita, Shouhei Moriyama, Kei Irie, Hirotaka Noda, Taku Yokoyama, Mitsuhiro Fukata, Takeshi Arita, Keita Odashiro, Toru Maruyama, Koichi Akashi
A 51-year-old man with a resuscitation episode was referred to our hospital. Coronary angiography revealed a focal spasm overlapped with organic stenosis where a bare metal stent was implanted. Acetylcholine (ACh) provocation test did not induce chest pain. It revealed no discernible ST-T changes but unmasked a J wave at the end of the QRS complex, which was associated with short-coupled repetitive premature ventricular beats. A J wave reportedly appears immediately before the onset of ventricular fibrillation caused by vasospastic angina...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28604190/the-use-of-a-stent-retriever-to-cause-mechanical-dilatation-of-a-vasospasm-secondary-to-iatrogenic-subarachnoid-haemorrhage
#12
Pervinder Bhogal, Dimitris Paraskevopoulos, Hegoda Ld Makalanda
Objective To report the use of a stent-retriever in the management of vasospasm secondary to craniopharyngioma resection. Postoperative improvement was seen both clinically and on perfusion imaging. Methods A patient was admitted for resection of a large craniopharygioma. On day 6 postoperatively the patient had an acute hemiparesis. A computed tomography angiogram and perfusion scan demonstrated acute right-sided cerebral vasospasm and a perfusion defect in the territory of the middle cerebral artery (MCA)...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28597450/effect-of-visible-light-on-vasospasticity-of-post-subarachnoid-hemorrhage-cerebrospinal-fluid
#13
Pulat Akin Sabanci, Bulent Omay, Yavuz Aras, Aydın Aydoseli, Achmet Ali, Tulin Erdem, Altay Sencer, Talat Kiris
Background and Objective Cerebral vasospasm (CV) is a serious complication of subarachnoid hemorrhage (SAH) with high morbidity and mortality rates. The mechanism of CV has not been determined. There are many theories related to this unsolved issue, one of which supports CV as a two-stage phenomenon from a pathophysiologic perspective. The first stage consists of inhibition of neuronal nitric oxide synthase by oxyhemoglobin, which results in a decrease of nitric oxide (NO) production. The second stage consists of an increase in the levels of asymmetric dimethylarginine through bilirubin oxidation products (BOXes), which are oxidized by-products of hemoglobin metabolism...
June 8, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28592384/gender-differences-in-long-term-clinical-outcomes-and-prognostic-factors-in-patients-with-vasospastic-angina
#14
Da Hyon Lee, Taek Kyu Park, Choong Sil Seong, Hye Bin Gwag, A Young Lim, Min Seok Oh, Sung Woo Cho, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Seung-Hyuk Choi
BACKGROUND: Men are more likely to suffer from vasospastic angina (VSA) than women; however, gender differences in the long-term prognosis of VSA patients have not been fully elucidated. We sought to investigate clinical outcomes and predictive factors of VSA patients according to gender. METHODS: A total of 986 patients (838 men and 148 women) with a positive result on intracoronary ergonovine provocation test between January 2003 and December 2014 were analyzed...
May 26, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28587834/spasmogenic-effects-of-the-proteasome-inhibitor-carfilzomib-on-coronary-resistance-vascular-tone-and-reactivity
#15
Carol Chen-Scarabelli, Giovanni Corsetti, Evasio Pasini, Francesco S Dioguardi, Gagan Sahni, Jagat Narula, Mara Gavazzoni, Hemang Patel, Louis Saravolatz, Richard Knight, Riccardo Raddino, Tiziano M Scarabelli
BACKGROUND: Carfilzomib (CFZ) is a new proteasome inhibitor used for the treatment of multiple myeloma. Besides heart failure, angina and myocardial ischemia occurred following administration of CFZ, which is not contraindicated in patients with recent myocardial infarction/unstable angina excluded from the safety trials. AIM OF STUDY: To test the effects of CFZ (10(-9) to 10(-7)mol/L) on vascular tone and reactivity in the isolated rabbit heart and aorta. METHODS AND RESULTS: CFZ administered by bolus injection to the isolated heart increased coronary perfusion pressure (CPP) at all tested concentrations and mildly raised left ventricular pressure and heart rate, only at the highest concentration...
July 2017: EBioMedicine
https://www.readbyqxmd.com/read/28539572/malondialdehyde-modified-low-density-lipoprotein-as-oxidative-stress-marker-in-vasospastic-angina-patients
#16
Tetsuo Oumi, Toshihiro Nozato, Atsushi Sakakibara, Hidetsugu Nomoto, Masakazu Ohno, Yoshihide Takahashi, Takashi Ashikaga, Yasuhiro Satoh, Mitsuaki Isobe
Vasospastic angina (VSA) is caused by endothelial dysfunction and hypercontraction of vascular smooth muscle cells. Although oxidative-stress can induce endothelial dysfunction, the relationship of VSA and the oxidative-stress marker malondialdehyde-modified low density lipoprotein (MDA-LDL) remains unclear. PURPOSE: Serum MDA-LDL was evaluated in candidate VSA patients.The subjects were 84 patients admitted to our hospital because of chest pain at rest. We stratified the patients into 3 groups; definite VSA, suspected VSA, and unlikely VSA according to a Japanese Circulation Society (JCS) guideline...
May 31, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28523890/handy-hints-about-raynaud-s-phenomenon-in-children-a-critical-review
#17
REVIEW
Donato Rigante, Michele Fastiggi, Francesco Ricci, Francesca D'Errico, Benedetta Bracci, Cristina Guerriero
Raynaud's phenomenon (RP) is a vasospastic disorder characterized by recurrent self-limited episodes of skin pallor, cyanosis, and hyperemia caused by paroxysmal spasms in the small arteries of the fingers and toes and can occur in any age group. Hands, feet, nose, ears, and nipples can be affected. The diagnosis is made clinically, assessing varying degrees of ischemia in the involved areas of skin, but this transient ischemia may also herald the onset of connective tissue disease. Investigation is recommended when RP starts in childhood to exclude an underlying autoimmune condition and close follow-up for its development...
May 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28473918/vasospastic-myocardial-infarction-caused-by-a-slimming-agent-do-not-forget-non-prescription-drugs
#18
Mohammed Omer Anwar, Neil Bodagh, Mohammed Husnain Iqbal, Adam Timmis
A 41-year-old woman presented with central chest discomfort. She had been previously well, was an ex-smoker and reported no regular medication. The ECG developed T-wave changes inferiorly and anterolaterally and troponin I concentrations were elevated confirming non-ST elevation myocardial infarction. Cardiac catheterization showed severe spasm of the right and left anterior descending coronary arteries which resolved with intracoronary nitrates. She later volunteered that prior to presentation she had been taking non-prescription Acti-Phen a slimming agent containing phentermine...
April 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28471897/thrombolyic-and-vasodilator-treatment-in-a-patient-with-prolonged-retinal-ischemia
#19
Sri Raghav Sista, John H Pula, Deepak Reddy, Chris Abdo, Sarah Parker, Mark A Getz, Jorge C Kattah
Vasospastic transient monocular vision loss associated with systemic lupus erythematosus and antiphospholipid syndrome is typically short lasting and responsive to vasodilators. Virchow's triad of endothelial dysfunction, arterial stasis, and a hypercoagulable state are factors in systemic lupus erythematosus/antiphospholipid syndrome that may potentially contribute to prolonged retinal hypoperfusion and central retinal artery occlusion. Consequently, rapid intervention to address all components of Virchow's triad may increase the probability of a good outcome...
May 2017: Neurologist
https://www.readbyqxmd.com/read/28468328/heparin-and-heparin-derivatives-in-post-subarachnoid-hemorrhage-brain-injury-a-multimodal-therapy-for-a-multimodal-disease
#20
REVIEW
Erik G Hayman, Akil P Patel, Robert F James, J Marc Simard
Pharmacologic efforts to improve outcomes following aneurysmal subarachnoid hemorrhage (aSAH) remain disappointing, likely owing to the complex nature of post-hemorrhage brain injury. Previous work suggests that heparin, due to the multimodal nature of its actions, reduces the incidence of clinical vasospasm and delayed cerebral ischemia that accompany the disease. This narrative review examines how heparin may mitigate the non-vasospastic pathological aspects of aSAH, particularly those related to neuroinflammation...
May 2, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
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