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Variant angina

Abraham Speedie, Cinosh Mathew, Rashmi Kerr, Rajneesh Calton
Coronary artery anomalies include anomalies of origin, termination, structure or course. Coronary artery fistulae (CAF) are classified as abnormalities of termination and are considered a major congenital anomaly. A coronary artery fistula involves a sizable communication between a coronary artery, bypassing the myocardial capillary bed and entering either a chamber of the heart (coronary-cameral fistula) or a great vessel. Bilateral coronary artery fistula, are a rare variant. We describe a bilateral CAF with angina and significant coronary artery disease requiring percutaneous coronary intervention...
August 2016: Journal of the Association of Physicians of India
Myoung Jin Ko, Yong Han Kim, Eunsu Kang, Byeong-Cheol Lee, Sujung Lee, Jae-Wook Jung
A 76-year-old man with no notable medical history was scheduled for a robot-assisted radical prostatectomy. After the operation, he was given sugammadex. Two minutes later, ventricular premature contraction bigeminy began, followed by cardiac arrest. Cardiac arrest occurred three times and cardiopulmonary resuscitation was done. The patient recovered after the third cardiopulmonary resuscitation and was transferred to the intensive care unit. Coronary angiography was done on postoperative day 1. The patient was diagnosed with variant angina and discharged uneventfully on postoperative day 8...
October 2016: Korean Journal of Anesthesiology
Tomonori Akasaka, Daisuke Sueta, Yuichiro Arima, Noriaki Tabata, Seiji Takashio, Yasuhiro Izumiya, Eiichiro Yamamoto, Megumi Yamamuro, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Ayami Kajiwara, Kazunori Morita, Kentaro Oniki, Junji Saruwatari, Kazuko Nakagawa, Yasuhiro Ogata, Kunihiko Matsui, 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 microvascular angina (MVA) caused by coronary microvascular dysfunction. METHODS AND RESULTS: We examined CYP2C19 genotypes in patients with MVA (n=71) and healthy subjects as control (n=71)...
September 23, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Hyung Il Kim, Kyoung Chul Cha, Yong Sung Cha, Oh Hyun Kim, Hyun Kim, Kang Hyun Lee, Min Soo Ahn, Jun Won Lee, Sung Oh Hwang
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Shuangshuang Zhang, Hongxiang Yan, Panpan Yu, Yulong Xia, Wenli Zhang, Jianping Liu
The present study was aimed to develope a proliposomal formulation to decrease the hepatic first-pass metabolism of protocatechualdehyde (PD), followed by pellet coating to modify the drug release for angina chronotherapy. PD proliposomes were prepared by depositing PD-phospholipid complex on mannitol powders to improve the drug encapsulation. Afterwards, the PD proliposomes were prepared into pellet cores via extrusion-spheronization using 10% κ-carrageenan as pelletization aid prior to the development of PD sustained-release pellets (PD-SRPs)...
October 10, 2016: European Journal of Pharmaceutical Sciences
Xue-Bin Wang, Ya-di Han, Shrestha Sabina, Ning-Hua Cui, Shuai Zhang, Ze-Jin Liu, Cong Li, Fang Zheng
A previous genome-wide association study showed that a single nucleotide polymorphism (SNP) rs2107595 in histone deacetylase 9 (HDAC9) gene was associated with large artery stroke (LAS) in Caucasians. Based on the similar atherosclerotic pathogenesis between LAS and coronary artery disease (CAD), we aimed to evaluate the associations of SNP rs2107595 with CAD risk and the severity of coronary atherosclerosis in a Chinese Han population, and explore the potential gene-environment interactions among SNP rs2107595 and conventional CAD risk factors...
2016: PloS One
Yunis Daralammouri, Malik Ghannam, Bernward Lauer
BACKGROUND: A normal anatomy of coronary arteries is important to have adequate cardiac muscle blood supply especially during extraneous physical activities. This case report describes a rare coronary anomaly in which the accessory coronary artery arose from the right coronary artery, reentered the left anterior descending coronary artery, and then ran as a single vessel. CASE PRESENTATION: We present a case of a coronary anomaly in a 47-year-old white man who presented with atypical angina...
2016: Journal of Medical Case Reports
Fatma Merve Tepetam, Bahadır Dağdeviren, İsmet Bulut, Can Yücel Karabay, Safa Barış, Elif Aydıner Karakoç
Kounis syndrome (KS) is a rarely diagnosed condition which should always be kept in mind when an acute myocardial infarction (AMI) happens in the context of anaphylactic reactions. We report a case of a 31-year old female; 2 hours after the ingestion of the mushroom (Pleurotus ostreatus); she experienced nausea, stomachache, vomiting, dyspnea and chest pain. Electrocardiogram (ECG) showed an ST segment elevation in D1, AVL, precordial leads V1-V4. The blood analysis revealed high levels of CK-MB fraction and troponin T values...
June 2016: Tüberküloz Ve Toraks
Petr A Sarapultsev, Alexey P Sarapultsev
In 2006, Takotsubo syndrome (TTC) was described as a distinct type of stress-induced cardiomyopathy (stress cardiomyopathy). However, when thinking about Takotsubo cardiomyopathy from the viewpoints of the AHA and ESC classifications, 2 possible problems may arise. The first potential problem is that a forecast of disease outcome is lacking in the ESC classification, whereas the AHA only states that 'outcome is favorable with appropriate medical therapy'. However, based on the literature data, one can make a general conclusion that occurrence of myocardial lesions in TTC (i...
October 15, 2016: International Journal of Cardiology
Musa A Ahmed, Abir Rghigh
Endothelin-1, (ET-1, EDN1) is endogenous polypeptide demonstrates dominant vasoconstriction activity and mitogenic effect, on the heart it has positive inotropic and chronotropic properties, stimulates the sympathetic and the renin-angiotensin-aldosterone systems and modify homeostasis. The human ET-1 gene which consists of 6836 nucleotides located on chromosome 6p23-p24 produces Pre-pro-ET-1, which consequently cleaved to big-ET-1. The mature 21-amino acid ET-1 is generated by subsequent enzymatic cleavage of the big-ET-1...
June 30, 2016: Current Clinical Pharmacology
Julia H Indik
No abstract text is available yet for this article.
July 12, 2016: Journal of the American College of Cardiology
Jung-Min Ahn, Ki Hong Lee, Sang-Yong Yoo, Young-Rak Cho, Jon Suh, Eun-Seok Shin, Jae-Hwan Lee, Dong Il Shin, Sung-Hwan Kim, Sang Hong Baek, Ki Bae Seung, Chang-Wook Nam, Eun-Sun Jin, Se-Whan Lee, Jun-Hyok Oh, Jae Hyun Jang, Hyung Wook Park, Nam Sik Yoon, Jeong Gwan Cho, Cheol Hyun Lee, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Jun Kim, Young-Hak Kim, Ki-Byung Nam, Cheol Whan Lee, Kee-Joon Choi, Jae-Kwan Song, You-Ho Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The long-term prognosis of patients with variant angina presenting with aborted sudden cardiac death (ASCD) is unknown. OBJECTIVES: The purpose of this study was to evaluate the long-term mortality and ventricular tachyarrhythmic events of variant angina with and without ASCD. METHODS: Between March 1996 and September 2014, 188 patients with variant angina with ASCD and 1,844 patients with variant angina without ASCD were retrospectively enrolled from 13 heart centers in South Korea...
July 12, 2016: Journal of the American College of Cardiology
Gaetano A Lanza, Giulia Careri, Alessandra Stazi, Angelo Villano, Antonio De Vita, Cristina Aurigemma, Filippo Crea
BACKGROUND: Because approximately 10% of patients with no-ST-segment elevation acute coronary syndrome (NSTE-ACS) show no obstructive coronary artery disease (NOCAD) on angiography, we assessed the spectrum of diagnoses and the predictors of outcome of these patients. METHODS AND RESULTS: We studied 178 patients admitted to a coronary care unit with an initial diagnosis of NSTE-ACS, based on clinical, ECG and laboratory data, but found to have NOCAD. The final diagnosis in these patients was heterogeneous; true NSTE-ACS (ie, coronary thrombosis on an unstable plaque) was ascertained in 1 patient (0...
June 24, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Tatsuo Naito
A 47-year-old woman with aspirin-exacerbated respiratory disease visited our hospital complaining of persistent chest pain that manifested in the evenings and early mornings. Holter monitoring revealed ST elevation during chest pain and coronary angiography showed coronary vasospasm, which led to the diagnosis of variant angina. Chest pain persisted despite administration of a coronary vasodilator. The patient experienced an increase in peripheral blood eosinophils during the clinical course and received prednisolone for the same, which resulted in the resolution of her chest pain...
March 2016: Arerugī, [Allergy]
Hack-Lyoung Kim, Sang Hyung Lee, Jayeun Kim, Hyun Joo Kim, Woo-Hyun Lim, Jae-Bin Seo, Woo-Young Chung, Sang-Hyun Kim, Joo-Hee Zo, Myung-A Kim, Jin Yong Lee
This study aimed to determine the incidence and the risk factors of hospitalization for variant angina (VA) in Korean patients. Using the National Inpatient Sample (NIS) database, manufactured and released by the Health Insurance Review and Assessment Service (HIRA) in Korea, the incidence of hospitalization and rehospitalization for VA were calculated. The numbers of patients hospitalized for VA were estimated to be 14,362 in 2009, 17,492 in 2010, and 20,592 in 2011. The standardized incidence rates of hospitalization for VA were 31...
March 2016: Medicine (Baltimore)
Dheeraj D Bhatt, Ranjan Kachru, Sanjay Gupta, Upendra Kaul
Spontaneous coronary artery dissection (SCAD) is a rare entity. It has been described in various settings like pregnancy, collagen vascular diseases, cocaine abuse, heavy exercise, variant angina, eosinophilic arteritis, or fibro muscular dysplasia. It is also easy to miss a dissection during angiography, as the typical radiolucent lumen seen in coronary angiography may be absent in many cases. In this report, we describe the case of a 35-year-old female who presented with acute ST elevation myocardial infarction due to spontaneous coronary dissection...
December 2015: Indian Heart Journal
Nicholas G Kounis
Kounis syndrome has been established as a hypersensitivity coronary disorder induced by various conditions, drugs, environmental exposures, foods and coronary stents. Allergic, hypersensitivity, anaphylactic and anaphylactoid reactions are associated with this syndrome. Vasospastic allergic angina, allergic myocardial infarction and stent thrombosis with occluding thrombus infiltrated by eosinophils and/or mast cells constitute are the three reported, so far, variants of this syndrome. Apart from coronary arteries, it affects the cerebral and mesenteric arteries...
October 1, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Xuming Dai, Szymon Wiernek, James P Evans, Marschall S Runge
Atherosclerotic coronary artery disease (CAD) comprises a broad spectrum of clinical entities that include asymptomatic subclinical atherosclerosis and its clinical complications, such as angina pectoris, myocardial infarction (MI) and sudden cardiac death. CAD continues to be the leading cause of death in industrialized society. The long-recognized familial clustering of CAD suggests that genetics plays a central role in its development, with the heritability of CAD and MI estimated at approximately 50% to 60%...
January 26, 2016: World Journal of Cardiology
Soo Jin Kim, Ji Young Juong, Tae-Ho Park
A 68-year-old man was admitted for a syncope workup. After routine evaluation, he was diagnosed with syncope of an unknown cause and was discharged from the hospital. He was readmitted due to dizziness. On repeated Holter monitoring, polymorphic ventricular tachycardia was detected during syncope. We performed intracoronary ergonovine provocation test; severe coronary spasm was induced at 70% stenosis of the proximal left anterior descending artery. The patient was treated with percutaneous coronary intervention...
January 2016: Korean Circulation Journal
Filippo Fassio, Laura Losappio, Dario Antolin-Amerigo, Silvia Peveri, Gianni Pala, Donatella Preziosi, Ilaria Massaro, Gabriele Giuliani, Chiara Gasperini, Marco Caminati, Enrico Heffler
Kounis syndrome is defined as the co-incidental occurrence of an acute coronary syndrome with hypersensitivity reactions following an allergenic event and was first described by Kounis and Zavras in 1991 as an allergic angina syndrome. Multiple causes have been described and most of the data in the literature are derived from the description of clinical cases - mostly in adult patients - and the pathophysiology remains only partly explained. Three different variants of Kounis syndrome have been defined: type I (without coronary disease) is defined as chest pain during an acute allergic reaction in patients without risk factors or coronary lesions in which the allergic event induces coronary spasm that electrocardiographic changes secondary to ischemia; type II (with coronary disease) includes patients with pre-existing atheromatous disease, either previously quiescent or symptomatic, in whom acute hypersensitive reactions cause plaque erosion or rupture, culminating in acute myocardial infarction; more recently a type-III variant of Kounis syndrome has been defined in patients with preexisting coronary disease and drug eluting coronary stent thrombosis...
May 2016: European Journal of Internal Medicine
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