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coronary artery spasm

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https://www.readbyqxmd.com/read/28634554/false-positive-transit-time-flowmetry-graft-failure-in-multivessel-coronary-spasm-following-off-pump-coronary-artery-bypass-grafting
#1
George Kassimis, George Krasopoulos
Intraoperative Transit Time Flowmetry is currently recommended to assess graft patency during coronary artery bypass grafting (CABG), especially in presence of haemodynamic instability or inability to wean the patient from cardiopulmonary bypass, new regional wall motion abnormalities, or significant ventricular arrhythmias. The VeriQ™ system is one of the currently available systems, which detects imperfections that may be corrected by graft revision. In this case report, multivessel coronary spasm (CS) post-CABG interferes with these intraoperative parameters misleading initially into false results...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28622945/safety-of-intracoronary-provocative-testing-for-the-diagnosis-of-coronary-artery-spasm
#2
Giuseppe Ciliberti, Sreenivasa Rao Kondapally Seshasai, Giuseppe Ambrosio, Juan Carlos Kaski
AIMS: Systematic review of literature to evaluate safety of intracoronary (i.c.) pharmacologic testing with acetylcholine (ACh), or ergonovine (ERGO), to induce coronary artery spasm. METHODS AND RESULTS: Review of all relevant publications using MEDLINE and EMBASE databases yielded 10 publications, totalling 9,444 patients. Prevalence of provoked spasm varied from 2.3% to 54.7% of patients tested in the selected studies. The wide variability in prevalence was due to heterogeneity of study populations and provocation protocols...
June 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28616567/cyp2c19-variants-and-epoxyeicosatrienoic-acids-in-patients-with-microvascular-angina
#3
Tomonori Akasaka, Daisuke Sueta, Yuichiro Arima, Noriaki Tabata, Seiji Takashio, Yasuhiro Izumiya, Eiichiro Yamamoto, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Ayami Kajiwara, Kazunori Morita, Kentaro Oniki, Junji Saruwatari, Kazuko Nakagawa, Seiji Hokimoto
BACKGROUND: Categorization as a cytochrome P450 (CYP) 2C19 poor metabolizer (PM) is reported to be an independent risk factor for cardiovascular disease. Epoxyeicosatrienoic acids (EETs) are metabolites of arachidonic acid by CYP2C19 epoxygenases and anti-inflammatory properties, especially in microvascular tissues. We examined the impact of CYP2C19 polymorphisms and EETs on the patients with microvascular angina (MVA) caused by coronary microvascular dysfunction. METHODS AND RESULTS: We examined CYP2C19 genotypes in patients with MVA (n = 81)...
June 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28606950/pathophysiology-of-takotsubo-syndrome
#4
REVIEW
Francesco Pelliccia, Juan Carlos Kaski, Filippo Crea, Paolo G Camici
Originally described by Japanese authors in the 1990s, Takotsubo syndrome (TTS) generally presents as an acute myocardial infarction characterized by severe left ventricular dysfunction. TTS, however, differs from an acute coronary syndrome because patients have generally a normal coronary angiogram and left ventricular dysfunction, which extends beyond the territory subtended by a single coronary artery and recovers within days or weeks. The prognosis was initially thought to be benign, but subsequent studies have demonstrated that both short-term mortality and long-term mortality are higher than previously recognized...
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28594339/cardiac-dysrhythmias-associated-with-substitutive-use-of-loperamide-a-systematic-review
#5
Irbaz Bin Riaz, Muhammad Shahzeb Khan, Muhammad Umar Kamal, Qurat-Ul-Ain Riaz Sipra, Anum Riaz, Umar Zahid, Sandipan Bhattacharjee
BACKGROUND: Recently, several deaths secondary to cardiac arrhythmias have been reported in association with substitutive use of loperamide. Therefore, we conducted a systematic review of all reported cases to overview the epidemiologic patterns and clinical outcomes to better elucidate loperamide-induced cardiac complications. AREAS OF UNCERTAINTY: Association between substitutive use of loperamide and cardiac arrhythmias. DATA SOURCES: A comprehensive literature search was conducted across 6 databases using variety of keywords to identify all reports of cardiac side effects associated with loperamide abuse...
April 27, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28526473/coronary-flow-reserve-is-reduced-in-sarcoidosis
#6
Seref Kul, Gonul Aciksari Kutlu, Tolga Sinan Guvenc, Murat Kavas, Kenan Demircioglu, Yusuf Yilmaz, Halil Ibrahim Yakar, Asiye Kanbay, Sibel Boga, Mustafa Caliskan
BACKGROUND AND AIMS: Sarcoidosis is a multisystem disease with frequent cardiac involvement, albeit manifest cardiac disease is rare. Though epicardial coronary arteries are not frequently involved, microvascular disease is rather common in both symptomatic and asymptomatic patients. The mechanism of microvascular involvement has not been elaborated yet. The aim of this study is to investigate coronary flow velocity reserve (CFVR) using transthoracic echocardiography in patients with sarcoidosis but without known atherosclerotic coronary artery disease or risk factors for atherosclerosis...
May 4, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28499220/effects-of-preadmission-beta-blockers-on-neurogenic-stunned-myocardium-after-aneurysmal-subarachnoid-hemorrhage-a-meta-analysis
#7
Hai Luo, Wei-Xin Song, Jin-Wen Jiang, Jian-Lan Zhao, Wei-Lin Rong, Mei-Hua Li
OBJECTIVE: Spontaneous subarachnoid hemorrhage is mostly caused by the rupture of an aneurysm. Neurogenic stunned myocardium (NSM) is one of the most frequent complications caused by aneurysmal subarachnoid hemorrhage (aSAH). The possible pathogenesis of NSM may be that the catecholamine peak resulting from aSAH leads to subendocardial ischemia or coronary artery spasm. We designed this meta-analysis to find out whether beta-blockers (BB) can significantly reduce the incidence of NSM and improve the outcomes of aSAH...
July 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28476516/effects-of-neuropeptide-y-on-coronary-artery-vasomotion-in-patients-with-microvascular-angina
#8
Giuseppe M C Rosano, Dimitris Tousoulis, Eugene McFadden, John Clarke, Graham J Davies, Juan Carlos Kaski
BACKGROUND: Patients with microvascular angina (exertional angina, positive exercise tests and normal coronary arteriograms) usually have a reduced coronary blood flow reserve. Neuropeptide Y (NPY) is a potent endogenous vasoconstrictor involved in modulation of coronary vasomotor tone and may play a role in microvascular angina. METHODS: We compared the effects of NPY (0.2-1.0pmol/kg, intracoronary) on the vasomotor response of proximal and distal segments of the coronary arteries in 7 patients with microvascular angina, 9 with chronic stable angina, and 9 control individuals...
March 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28473918/vasospastic-myocardial-infarction-caused-by-a-slimming-agent-do-not-forget-non-prescription-drugs
#9
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/28461799/phasic-compression-of-left-circumflex-coronary-artery-during-atrial-systole
#10
Edward Samuel Roberto, Ajay Agarwal
Phasic coronary artery compression is typically associated with spasm or myocardial bridging. Compression caused by acquired anatomic changes to the surrounding heart chambers has been reported only infrequently. We present a possibly unique case of phasic compression of the proximal left circumflex coronary artery during atrial contraction in association with a dilated left atrium. A 55-year-old man with multiple cardiac risk factors presented with worsening exertional dyspnea. An electrocardiogram and echocardiogram revealed marked left atrial dilation and a left ventricular ejection fraction of 0...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28457806/detection-of-spontaneous-coronary-artery-spasm-with-optical-coherence-tomography-in-a-patient-with-acute-coronary-syndrome
#11
HanyTawfik Fathelbab, Santiago Jesús Camacho Freire, Javier León Jiménez, Rosa Cardenal Piris, Antonio Enrique Gómez Menchero, Jessica Roa Garrido, José Francisco Díaz Fernández
We present 2 illustrative cases of acute coronary syndrome and spontaneous coronary artery spasm evaluated by optical coherence tomography. Different spasm patterns were showed by optical coherence tomography (OCT), according to whether there were underlying atherosclerotic plaques or not.
February 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28457560/three-year-follow-up-of-patients-with-acetylcholine-induced-coronary-artery-spasm-combined-with-insignificant-coronary-stenosis
#12
Byoung Geol Choi, Sung Hun Park, Seung-Woon Rha, Jihun Ahn, Se Yeon Choi, Jae Kyeong Byun, Hu Li, Ahmed Mashaly, Min Suk Shim, Jun Hyuk Kang, Woohyeun Kim, Jah Yeon Choi, Eun Jin 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: Coronary artery spasm (CAS) and significant coronary stenosis are known to be major causes of myocardial ischemia. However, their association and the impact of insignificant coronary stenosis (ICS) on long-term clinical outcomes of CAS patients are largely unknown. METHODS: A total of 2797 patients without significant coronary artery disease (CAD) who underwent the acetylcholine (ACH) provocation test between November 2004 and October 2010 were enrolled...
March 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28409033/aborted-sudden-cardiac-death-in-a-female-patient-presenting-with-takotsubo-like-cardiomyopathy-due-to-epicardial-coronary-vasospasm
#13
Sorin Giusca, Tom Eisele, Peter Nunninger, Benedikt Münz, Grigorios Korosoglou
Takotsubo cardiomyopathy is characterized by apical ballooning of the left ventricle (LV) in the absence of relevant coronary artery stenosis, which typically occurs in elderly women after emotional stress. Catecholamine cardiotoxicity, metabolic disturbance, and coronary microvascular impairment have previously been proposed as underlying pathophysiologic mechanisms of takotsubo cardiomyopathy, whereas myocardial stunning resulting from epicardial coronary artery vasospasm is not generally accepted as a cause of takotsubo cardiomyopathy...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28387796/long-term-prognosis-of-patients-with-life-threatening-ventricular-arrhythmias-induced-by-coronary-artery-spasm
#14
Moisés Rodríguez-Mañero, Teresa Oloriz, Jean-Benoit le Polain de Waroux, Haran Burri, Bahij Kreidieh, Carlos de Asmundis, Miguel A Arias, Elena Arbelo, Brais Díaz Fernández, Juan Fernández-Armenta, Nuria Basterra, María Teresa Izquierdo, Ernesto Díaz-Infante, Gabriel Ballesteros, Andrés Carrillo López, Ignacio García-Bolao, Juan Benezet-Mazuecos, Victor Expósito-García, Larraitz-Gaztañaga, Jose Luis Martínez-Sande, Javier García-Seara, Jose Ramón González-Juanatey, Rafael Peinado
Aims: Coronary artery spasm (CAS) is associated with ventricular arrhythmias (VA). Much controversy remains regarding the best therapeutic interventions for this specific patient subset. We aimed to evaluate the clinical outcomes of patients with a history of life-threatening VA due to CAS with various medical interventions, as well as the need for ICD placement in the setting of optimal medical therapy. Methods and results: A multicentre European retrospective survey of patients with VA in the setting of CAS was aggregated and relevant clinical and demographic data was analysed...
April 6, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28367849/acute-heart-failure-triggered-by-coronary-spasm-with-transient-left-ventricular-dysfunction
#15
Yusuke Adachi, Kenichi Sakakura, Tatsuro Ibe, Nanae Yoshida, Hiroshi Wada, Hideo Fujita, Shin-Ichi Momomura
Coronary spasm is abnormal contraction of an epicardial coronary artery resulting in myocardial ischemia. Coronary spasm induces not only depressed myocardial contractility, but also incomplete myocardial relaxation, which leads to elevated ventricular filling pressure. We herein report the case of a 55-year-old woman who had repeated acute heart failure caused by coronary spasm. Acetylcholine provocation test with simultaneous right heart catheterization was useful for the diagnosis of elevated ventricular filling pressure as well as coronary artery spasm...
April 6, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28345355/coronary-spasm-secondary-to-cefuroxime-injection-complicated-with-cardiogenic-shock-a-manifestation-of-kounis-syndrome-case-report-and-literature-review
#16
Andreas Mitsis, Evi Christodoulou, Panayiota Georgiou
Kounis syndrome is defined as the coincidental occurrence of an acute coronary syndrome with hypersensitivity reactions following an allergic event. The three reported variants of Kounis syndrome are vasospastic allergic angina, allergic myocardial infarction and stent thrombosis with occluding thrombus. The syndrome is caused by various inflammatory mediators. The pathophysiological characteristics of Kounis syndrome involve coronary artery spasm and/or atheromatous plaque erosion or rupture during an allergic reaction...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28331112/differential-incidence-and-morphology-of-spasm-according-to-coronary-arterial-location-by-intracoronary-ergonovine-spasm-provocation-testing
#17
Shozo Sueda, Hiroaki Kohno
BACKGROUND: We reported less provoked spasm in the left circumflex artery (LCX) by acetylcholine testing compared with the left anterior descending artery (LAD) and right coronary artery (RCA), so we investigated the clinical characteristics of provoked spasm in the LCX by ergonovine (ER) testing.Methods and Results:We retrospectively analyzed 1,185 consecutive cases of intracoronary ER testing during 25 years. Maximal ER dose was 64 μg into the left coronary artery (LCA) and 40 μg into the RCA...
March 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28319321/unrecognized-coronary-vasospasm-in-patients-referred-for-percutaneous-coronary-intervention-intracoronary-nitroglycerin-the-forgotten-stepchild-of-cardiovascular-guidelines
#18
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
#19
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
#20
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
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