Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coronary spastic angina (CSA) is relatively more common in young people than in elderly people. Here, we present three cases of elderly male patients who experienced out-of-hospital cardiac arrest (OHCA) likely due to coronary spasm-induced ventricular fibrillation (Vf) from 2013 to 2016. After defibrillation, emergency coronary arteriography demonstrated severe coronary vasospasm that resolved following intracoronary infusion of nitroglycerin in the right coronary arteries in all three patients, with no organic obstructive lesion in the coronary arteries after nitroglycerin infusion. Case 1 was a 74-year-old patient with a past history of unstable angina and no organic obstructive lesion on coronary arteriography. He was administered oral amlodipine, isosorbide mononitrate, and nicorandil. He survived an OHCA and underwent implantable cardioverter defibrillator (ICD) implantation on day 57. Case 2 was a 71-year-old patient without prior CSA, who suddenly lost consciousness during a break after tennis. Vf was reversed to sinus rhythm by defibrillation in the ambulance. He died of multi-organ failure on day 7. Case 3 was a 66-year-old patient diagnosed with multi-vessel CSA by coronary arteriography with acetylcholine provocation test. He survived an OHCA associated with inferior acute myocardial infarction, rejected ICD implantation, and has not had a chest pain attack or syncope since discharge. <Learning objective: This article reports a case series of out-of-hospital cardiac arrest (OHCA) likely due to coronary spastic angina (CSA) in the presence of non-obstructive coronary artery disease in elderly patients. Although CSA is associated with an increased risk of OHCA, little is known regarding clinical risk factors, the effectiveness of implanted defibrillators for the secondary prevention of cardiac arrest, or the long-term prognosis of elderly CSA patients who survive OHCA.>.
 ...
PMID:Out-of-hospital cardiac arrest related to coronary arterial spasm in three elderly patients with no obstructive coronary artery disease. 3027 23

Coronary spastic angina (CSA) in premenopausal women is rare, but has also been suggested to be associated with estrogen decline during the menstrual cycle. In this report, we describe the case of a young premenopausal patient with refractory CSA. She presented with ventricular fibrillation (VF) at the age of 15 years and was diagnosed as having CSA. She underwent implantation of an Implantable Cardioverter Defibrillator (ICD), and despite receiving systemic drug therapy at the maximum doses, she experienced a total of four appropriate ICD shocks over the subsequent six years. Based on careful history-taking, it was suspected that the angina episodes were closely related to the phase of the menstrual cycle. We started the patient on continuous combined estrogen-progestin hormone contraception therapy so as to prevent the reduction of the blood estrogen levels just prior to and during menstruation. After the start of this treatment, the patient became completely free of angina episodes. Although there are a few reports of the efficacy of hormone replacement therapy in premenopausal women with CSA, this is the first report of the efficacy of this therapy in a woman as young as 22 years old. <Learning objective: There are a few reports of episodes of CSA occurring in relation to the phase of the menstrual cycle in premenopausal women. It is considered to be associated with decline of the blood estrogen levels and combined estrogen plus progestin contraception therapy may be effective in such cases.>.
 ...
PMID:Efficacy of combined estrogen-progestin hormone contraception therapy for refractory coronary spastic angina in very young women. 3237 48