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Vasospastic angina

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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/28699981/exuberant-vasospastic-angina-simulating-severe-three-vessel-disease
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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/28592384/gender-differences-in-long-term-clinical-outcomes-and-prognostic-factors-in-patients-with-vasospastic-angina
#11
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
#12
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
#13
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/28429696/polymorphic-ventricular-tachycardia-due-to-variant-angina-diagnosed-on-holter-monitoring-and-confirmed-with-cold-pressor-test
#14
Semi Öztürk, Tuğba Aktemur, Muhsin Kalyoncuoğlu, Gündüz Durmuş, Mehmet Can
A 52-year-old man complaining of persistent recurring chest pain at night underwent coronary angiogram at another institution. Normal coronaries were observed and he was discharged with muscle spasmolytic prescription. Since symptoms had continued, 24-hour Holter monitoring was ordered at our facility and results revealed huge ST elevation and polymorphic ventricular tachycardia. Cold pressor test performed in catheterization laboratory also resulted in ventricular tachycardia. Nifedipine was prescribed and follow-up Holter monitoring revealed no further vasospastic episodes...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28429664/alternative-causes-of-myocardial-ischemia-in-women-an-update-on-spontaneous-coronary-artery-dissection-vasospastic-angina-and-coronary-microvascular-dysfunction
#15
REVIEW
Bina Ahmed, Mark A Creager
Although coronary obstruction due to atherosclerosis is the most common cause of myocardial ischemia, a significant proportion of patients have myocardial ischemia in the absence of obstructive epicardial coronary artery disease (CAD). This finding is more common among women and alternative causes can mediate myocardial ischemia. Abnormalities in vascular structure, alterations in coronary vasomotion and dysfunction of the coronary microcirculation can all cause ischemia in the absence of obstructive CAD due to atherosclerosis...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28400927/importance-of-a-second-spasm-provocation-test-four-cases-with-an-initial-negative-spasm-provocation-test
#16
Hiroki Teragawa, Yuichi Fujii, Yuko Uchimura, Tomohiro Ueda
The spasm provocation test (SPT) is an important test in the diagnosis of vasospastic angina (VSA). In many cases, this test is performed as the gold standard test, and VSA is considered not present if the SPT is negative. However, some patients continue to experience chest symptoms despite a negative SPT. In this study, we report four cases in which SPT was repeated to evaluate chest symptoms despite the negative results of the first SPT. Two men in their 70s, one woman in her 60s, and one woman in her 70s, all with chest symptoms, underwent a second SPT at 4, 3, 2, and 3 years, respectively, after the first SPT, which was negative...
March 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28378733/-prognostic-factors-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-concurrent-with-type-2-diabetes-mellitus-according-to-the-results-of-the-registry
#17
A P Golikov, S A Berns, R I Stryuk, E A Shmidt, A A Golikova, O L Barbarash
AIM: To investigate factors that influence annual prognosis in patients with non-ST-segment elevation acute coronary syndrome ((NSTEACS) concurrent with type 2 diabetes mellitus (DM2). SUBJECTS AND METHODS: The registry of patients with NSTEACS (non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina) included 415 patients, of them 335 had no carbohydrate metabolic disorders, 80 had DM2. The follow-up period, during which the prognosis was evaluated in the patients, was one year after hospital discharge following the index NSTEACS event...
2017: Terapevticheskiĭ Arkhiv
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
#18
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/28296760/fluctuations-in-the-amplitude-of-st-segment-elevation-in-vasospastic-angina-two-case-reports
#19
Ming-Jui Hung
RATIONALE: ST-segment elevation localizes an ischemic lesion to the coronary artery supplying the area of the myocardium reflected by the electrocardiographic leads. Dynamic ST-segment elevation can be due to severe transmural ischemia secondary to a thrombus, vasospasm, or a tightly fixed coronary artery lesion or a combination of these situations. PATIENT CONCERNS: In this study, we report on two patients with angina who had fluctuations in ST-segment amplitude on serial electrocardiograms...
March 2017: Medicine (Baltimore)
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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