1/50. Coronary spasm during outpatient fiberoptic laser bronchoscopy.A 63-year-old woman with metastatic breast cancer was referred to our bronchoscopy unit for outpatient laser resection of an endobronchial mass through fiberoptic bronchoscopy. The patient had no history of ischemic heart disease. During the procedure, the patient developed an ST-segment elevation and a complete atrioventricular block. IV nitroglycerin and morphine were effective in treating this episode. In this patient, we were able to demonstrate a focal spasm by postbronchoscopy coronary angiography.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/50. Coronary spasm with ventricular fibrillation during thyrotoxicosis: response to attaining euthyroid state.Although myocardial ischemia may occur in thyrotoxic patients with normal coronary arteries, the mechanism remains unclear. This report describes a woman with hyperthyroidism who had ventricular fibrillation during an apisode of myocardial ischemia. The event was documented with continuous ambulatory electrocardiography. Subsequent angiography revealed normal coronary anatomy with spasm of the right coronary artery that disappeared after ingestion of one sublingual nitroglycerin tablet. The angina, electrocardiographic evidence of myocardial ischemia, ventricular arrhythmias and the patient's need for nitroglycerin were eliminated after she became euthyroid. These findings suggest that coronary spasm may be associated with myocardial ischemia and arrhythmias in a hyperthyroid patient.- - - - - - - - - - ranking = 4keywords = coronary (Clic here for more details about this article) |
3/50. pseudoxanthoma elasticum with dipyridamole-induced coronary artery spasm: a case report.In patients with pseudoxanthoma elasticum, severe organic coronary artery stenosis often occurs without coronary risk factors. However, this report presents the case of a 49-year-old woman with pseudoxanthoma elasticum who had coronary artery spasm with an angiographically normal coronary artery. In addition, coronary artery spasm was provoked with dipyridamole thallium-201 cardiac imaging.- - - - - - - - - - ranking = 9keywords = coronary (Clic here for more details about this article) |
4/50. Stress long-axis function in coronary artery spasm.In a patient with prior myocardial infarction who had complained of frequent angina repeat arteriograms proved normal coronary arteries. Both ECG exercise testing and thallium scanning excluded ischemia. Resting echocardiogram showed increased distal septal and right ventricular apical myocardial echo intensity. dobutamine stress echo demonstrated right ventricular and posteroseptal abnormalities consistent with ischemia. Repeat angiogram with ergonovine confirmed distal right coronary spasm.- - - - - - - - - - ranking = 6keywords = coronary (Clic here for more details about this article) |
5/50. Refractory vasospasm with a malignant course.We present a patient with two rare disorders, recurrent vasospastic angina leading to cardiac transplant and acute aortic occlusion. The patient had recurrent episodes of coronary vasospasm presenting with unstable angina, acute myocardial infarction, and sudden cardiac death in spite of adequate therapy with nitrates and calcium-channel blockers. He went on to have a cardiac transplant. The patient later presented with acute aortic occlusion with concomitant renal and mesenteric artery spasm. The circumstances of the presentation raise the possibility of a generalized vasospastic predisposition that is responsible for both events. smoking, the only known major risk factor other than atherosclerosis, was noted to be temporally related to both events in our patient.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
6/50. Arteriographic demonstration of spontaneous right coronary artery spasm in a patient with Prinzmetal's angina.Coronary artery spasm may occur spontaneously during coronary angiography in patients with clinically documented or suspected Prinzmetal's angina. In other patients with Prinzmetal's angina, the spasm can be provoked by the administration of ergonovine. A patient with spontaneous spasm of the right coronary artery during coronary angiography is reported and some considerations for diagnosis and therapy of this entity is offered. Although intraoperative spasm has been reported in the cardiology literature, no such case has been described in the radiology literature.- - - - - - - - - - ranking = 7keywords = coronary (Clic here for more details about this article) |
7/50. Recurrent myocardial infarction and angina in a woman with normal coronary angiograms.A case is reported of recurrent myocardial infarction and angina pectoris in a woman with normal coronary arteries documented by coronary angiogram. The recurrence of infarction in contiguous areas of the heart supplied by the left anterior descending coronary artery and the association of the anginal syndrome implicate coronary arterial spasm as the probable cause.- - - - - - - - - - ranking = 8keywords = coronary (Clic here for more details about this article) |
8/50. Coronary angiographic, echocardiographic, and electrocardiographic studies on a patient with variant angina due to coronary artery spasm.A 45-year-old Caucasian female patient with a clinical rehistory and ECG's conforming to the syndrome of variant angina as characterized by Prinzmetal is presented. ECG's recorded during spontaneous pain demonstrated ST-segment elevation and symmetrical peaking of the T-waves in the lateral precordial leads and short runs of ventricular tachycardia. Similar ECG changes were recorded during treadmill exercise- and hand-grip exercise-induced chest pain. An echocardiogram recorded during angina induced by hand-grip exercise demonstrated progressive flattening of septal motion. Multiple views of the coronary system by selective coronary cineangiography were normal with the patient at rest. Angina was then induced by hand-grip exercise and a repeat right anterior oblique view of the left coronary system revealed marked spasm of the left anterior descending artery proximal to the first septal perforator.- - - - - - - - - - ranking = 7keywords = coronary (Clic here for more details about this article) |
9/50. Cardiac arrest related to coronary spasm in patients with variant angina: a three-case study.We present three patients with variant angina pectoris and episodes of cardiac arrest. All of them had typical clinical symptoms, ST-segment changes in electrocardiogram, and coronary artery spasm confirmed by arteriography. They were treated with high doses of calcium antagonists and nitrates. An automatic cardioverter-defibrillator was implanted in the patient who developed ventricular fibrillation despite therapy with calcium antagonists. In another patient a DDD pacemaker was implanted because of high-degree atrioventricular block.- - - - - - - - - - ranking = 5keywords = coronary (Clic here for more details about this article) |
10/50. A case of coronary spasm induced by 5-fluorouracil.Cardiotoxicity is an uncommon adverse effect of 5-fluorouracil (5-FU). Coronary artery spasm has been postulated to be involved in the mechanism of this incident patients may present with angina, myocardial infarction, arrhythmias and/or even sudden death.When the drug is readministered, there is a high risk of relapse.The underlying mechanisms of cardiotoxicity are not yet fully understood, although coronary vasospasm may be responsible. We report one woman receiving 5-fluorouracil therapy with typical chest pain and electrocardiographic changes consistent with acute coronary syndrome. A resolving pain and normalisation of ECG changes with nitrate therapy and normal coronary arteries indicate that this incident was about a coronary spasm caused by 5-FU.- - - - - - - - - - ranking = 8keywords = coronary (Clic here for more details about this article) |
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