Transient electrocardiographic recording of acute myocardial ischemia with ST-segment elevation of the diaphragmal location accompanied by a total atrioventricular block as an initial manifestation of Prinzmetal’s angina - A case report

• Autorzy: Krunoslav Fuckar , Nenad Lakusic , Hrvoje Stipic
• Języki publikacji: EN

Abstrakty

EN

Prinzmetal’s angina, also known as Prinzmetal’s variant or Prinzmetal’s vasospastic angina is characterized by angina attacks caused by spasm of the great epicardial coronary arteries. Coronary artery endothelial dysfunction plays a crucial role in the development of this vasospastic angina. The attacks of vasospastic angina can be prevented with calcium antagonists and nitrates, whereas in refractory variant angina, coronary angioplasty with stenting may help prevent further coronary spasm. In this case report, we present a 52-year-old male patient with a transient electrocardiographic recording of acute myocardial ischemia with ST-segment elevation of the diaphragmal location accompanied by a total atrioventricular block immediately after exercise testing and as a first manifestation of Prinzmetal’s angina. After regression of the symptoms and electrocardiographic changes, significant pathomorphologic changes of coronary arteries were excluded by coronary angiography. Following discharge, the patient was treated with calcium antagonists and did not show symptoms during a 4-year follow-up period.

Słowa kluczowe

EN

Coronary disease; vasospasm; Prinzmetal’s angina; exercise

• Czasopismo: Open Medicine
• Rocznik: 2007
• Tom: 2
• Numer: 1
• Strony: 108-115

Daty

wydano

2007-03-01

online

2007-03-01

Twórcy

autor

Krunoslav Fuckar

• Department of Cardiology, Hospital for Medical Rehabilitation, Krapinske Toplice, Croatia,

autor

Nenad Lakusic

• Department of Cardiology, Hospital for Medical Rehabilitation, Krapinske Toplice, Croatia

autor

Hrvoje Stipic

• Department of Cardiology, Special Hospital for Cardiology And Cardiovascular Surgery “Magdalena”, Krapinske Toplice, Croatia

Bibliografia

• [1] E.J. Topol: Textbook of cardiovascular medicine, New York - Philadelphia, Lippincott Raven, 1998, pp. 345–60.
• [2] J.J. Li, J.M. Chu and C.Y. Zhang: “Variant angina in a 17-year old male”, Acta Cardiol., Vol. 60, (2005), pp. 69–71. http://dx.doi.org/10.2143/AC.60.1.2005054[Crossref]
• [3] M.E. Bertrand, M.L. Simoons, K.A. Fox, L.C. Wallentin, C.W. Hamm, E. de McFadden, P.J. Feyter, G. Specchia and W. Ruzyllo: “Management of acute coronary syndromes: acute coronary syndromes without persistent ST segment elevation; recommendations of the Task Force of the European Society of Cardiology”, Eur. Heart. J., Vol. 21, (2001), pp. 1406–1432. http://dx.doi.org/10.1053/euhj.2000.2301[Crossref]
• [4] S.B. Chaitman: “Exercise stress testing”, In: E. Braunwald: Heart disease, Elsevier Saunders, 2005, pp. 153–185.
• [5] T. von Arnim, H.W. Gerbig and A. Erath: “Arrhythmias in relation to transient ST elevation in Prinzmetal angina: induction by occlusion and reperfusion”, Z. Kardiol., Vol. 74, (1985), pp. 585–589.
• [6] Y. Miyao, K. Kugiyama, H. Kawano, T. Motoyama, H. Ogawa, M. Yoshimura, T. Sakamoto and H. Yasue: “Diffuse intimal thickening of coronary arteries in patients with coronary spastic angina”, J. Am. Coll. Cardiol., Vol. 36, (2000), pp. 432–437. http://dx.doi.org/10.1016/S0735-1097(00)00729-4[Crossref]
• [7] S. Takagi, Y. Goto, E. Hirose, M. Terashima, S. Sakuragi, S. Suzuki, Y. Tsutsumi, S. Miyazaki and H. Nonogi: “The preventive treatment of refractory vasospastic angina with corticosteroids: coronary arterial hyperactivity caused by local inflammation”, Circ. J., Vol. 68, (2004), p. 806. http://dx.doi.org/10.1253/circj.68.17[Crossref]
• [8] M.J. Hung, W.J. Cherng, C.W. Cheng and N.I. Yang: “Effect of antispastic agents (calcium antagonists and/or isosorbide dinitrate) on high-sensitivity C-reactive protein in patients with coronary vasospastic angina pectoris and no hemodynamically significant coronary artery disease”, Am. J. Cardiol., Vol. 95, (2005), pp. 84–87. http://dx.doi.org/10.1016/j.amjcard.2004.08.064[Crossref]
• [9] H. Teragawa, M. Kato, T. Yamagata, H. Matsuura and G. Kajiyama: “The preventive effect of magnesium on coronary spasm in patients with vasospastic angina”, Chest., Vol. 118, (2000), pp. 1690–1695. http://dx.doi.org/10.1378/chest.118.6.1690[Crossref]
• [10] T. Motoyama, H. Kawano, K. Kugiyama, O. Hirashima, M. Ohgushi, R. Tsunoda, Y. Moriyama, Y. Miyao, M. Yoshimura, H. Ogawa and H. Yasue: “Vitamin E administration improves impairment of endothelium-dependent vasodilatation in patients with coronary spastic angina”, J. Am. Coll. Cardiol., Vol. 32, (1998), pp. 1672–1679. http://dx.doi.org/10.1016/S0735-1097(98)00447-1[Crossref]
• [11] M. Meader, P. Ammann, W. Angehrn and H. Rickli: “A case of coronary vasospasm treated with stent placement”, Z. Kardiol., Vol. 92, (2003), pp. 182–187. http://dx.doi.org/10.1007/s00392-003-0882-y[Crossref]
• [12] G.A. Rodriguez-Granillo, E.P. McFadden, M. Valgimigli, C.A. van Mieghem, E. Regar, P.J. de Feyter and P.W. Serruys: “Coronary plaque composition of non culprit lesions, assessed by in vivo intracoronary ultrasound radio frequency data analysis, is related to clinical presentation”, Am. Heart J., Vol. 151, (2006), pp. 1020–1024. http://dx.doi.org/10.1016/j.ahj.2005.06.040[Crossref]
• [13] K. Sano, M. Kawasaki, M. Okubo, H. Yokohama, Y. Ito, I. Murata, T. Kawai, K. Tsuchiya, K. Nishigaki, G. Takemura, S. Minatoguchi, X. Zhou, H. Fujita and H. Fujiwara: “In vivo quantitative tissue characterization of angiographically normal coronary lesions and the relations with risk factor: a study using integrated backscatter intravascular ultrasound”, Circ. J., Vol. 69, (2005), pp. 543–549. http://dx.doi.org/10.1253/circj.69.543[Crossref]

Identyfikatory

DOI

10.2478/s11536-007-0003-9