Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This syndrome is due to focal spasm of an epicardial coronary artery, leading to severe myocardial ischemia. Although it is frequently thought that the spasm occurs in arteries without stenosis, many Prinzmetal patients have spasm adjacent to atheromatous plaques. The exact cause of the spasm has not been well defined, but it may be related to the hypercontractility of the vascular smooth muscle due to vasoconstrictor mitogens, leukotrienes, or serotonin. In some patients, it is a manifestation of a vasospastic disorder and it is associated with migraine, Raynaud's phenomenon, or aspirin-induced asthma. We present a case associated with transient ST-segment depression.
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PMID:Prinzmetal's angina. 1983 75

Variant (Prinzmetal's) angina is an uncommon cause of precordial pain caused by coronary vasospasm and characterized by transient ST elevation and negative markers of myocardial necrosis. This is the case of a female patient with a prior history of depression and panic attacks who presented with recurrent symptoms including chest pain. A cardiac event monitor positively documented coronary vasospasm associated with anxiety-provoking chest pain, whereas the coronary arteries were angiographically normal. We noted that the frequency of angina attacks apparently increased during the period that coincided with the introduction of Bupropion SR for treatment of the patient's depression. Considering the possibility of bupropion-associated negative impact on coronary vasospasm, the antidepressant therapy was adjusted to exclude this drug. Although Prinzmetal's angina is relatively uncommon, we suspect that a routine use of cardiac event monitors in subjects with panic disorder might reveal a greater incidence of coronary vasospasm in this patient population.
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PMID:Depression with panic episodes and coronary vasospasm. 2002 23

Prinzmetal-variant angina is a syndrome of chest pain caused by myocardial ischemia secondary to reversible coronary artery vasospasm, which may occur in angiographically normal and diseased coronary arteries. It typically occurs at rest and is accompanied by transient ST-segment elevation. Although the underlying pathophysiology is not well established, coronary spasm secondary to increased serotonergic activity as well as increased sympathetic activity may prevail. Coronary artery spasm can be invoked by antimigraine therapy and also by drugs having serotonergic activity such as ergonovine and ergotamine. Prinzmetal-variant angina may be complicated with acute myocardial infarction, ventricular arrhythmias as well as sudden cardiac death. We report a case of 48-year old woman presenting with chest pain and diffuse ST-segment elevation on electrocardiography during an episode of angina, while she was taking zolmitriptan 5 mg/d and citalopram 20 mg/d for migraine and depression, respectively. Coronary angiography (performed because of prolonged angina and presence of diffuse ST-segment elevation on electrocardiography) revealed that diffuse narrowing of left anterior descending coronary artery alleviated after intracoronary nitrate therapy. The most likely cause of myocardial infarction was coronary artery spasm because of the possible increased serotonergic activity secondary to concomitant use of zolmitriptan and citalopram.
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PMID:Prinzmetal-variant angina in a patient using zolmitriptan and citalopram. 2015 12


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