scholarly journals Rapid Progression of Coronary Atherosclerosis by Coronary Artery Spasm Leading to Acute Coronary Syndrome

Circulation ◽  
2009 ◽  
Vol 119 (16) ◽  
pp. 2233-2234 ◽  
Author(s):  
Ichiro Sakamoto ◽  
Masahiro Mohri ◽  
Hideo Yamamoto
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Atherosclerosis ◽  
Coronary Artery Spasm ◽  
Rapid Progression ◽  
Coronary Syndrome

scholarly journals KOUNIS SYNDROME - ALLERGIC MYOCARDIAL INFARCTION. A CASE REPORT

2019 ◽  
Vol 72 (1) ◽  
pp. 137-141
Author(s):  
Olga Wajtryt ◽  
Tadeusz M Zielonka ◽  
Aleksandra Kaszyńska ◽  
Andrzej Falkowski ◽  
Katarzyna Życińska
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Allergic Reaction ◽  
Anaphylactic Shock ◽  
Coronary Artery Spasm ◽  
Kounis Syndrome ◽  
Permanent Damage ◽  
Coronary Syndrome

Kounis syndrome or allergic myocardial infarction is an acute coronary syndrome in the course of an allergic reaction. In allergic patients in response to a specific condition - nourishment, inhalation, environmental substances, drug or insect bite there is an allergic reaction involving many different cells and mediators that can cause coronary artery spasm or initiate the process of rupture and activation of atherosclerotic plaque resulting in acute coronary syndrome. The paper describes a case of a young man with allergy to pollen and confirmed sensitization to nuts, who developed a full-blown anaphylactic shock after eating the nut mix and experienced a rapidly passing acute coronary syndrome with troponin up to 4.7 μg/L. An increased concentration of tryptase (15 μg/L), total IgE (> 3,000 IU/mL) and specific anti-nut IgE (55.1 kUA/L) were found. Based on the course of the disease and the results of allergic and cardiac tests, allergic type 1 myocardial infarction, i.e. caused by coronary artery spasm, was diagnosed. During the hospitalization, the patient’s condition improved quickly and after a few days he left the hospital without the signs of permanent damage to the heart muscle.

scholarly journals Long-term results of different approaches to revascularization in non-ST-segment elevation acute coronary syndrome and multiple coronary atherosclerosis

2017 ◽  
Vol 89 (4) ◽  
pp. 29-34 ◽  
Author(s):  
V I Ganyukov ◽  
R S Tarasov ◽  
Yu N Neverova ◽  
N A Kochergin ◽  
O L Barbarash ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Medical Treatment ◽  
Coronary Atherosclerosis ◽  
Long Term Results ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

Aim. To assess the long-term results of different approaches to treating patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) and multivessel coronary artery disease (MVCAD). Subjects and methods. A total of 150 patients with NSTE ACS, in whom coronary angiography revealed MVCAD, were examined. The patients were divided into 3 groups according to the selected treatment policy: 1) percutaneous coronary intervention (PCI) (n=91 (60.6%)); 2) coronary artery bypass grafting (CABG) (n=40 (26.6%)); and 3) only medical treatment (n=9 (6%)). The mean follow-up was 27.6±3.5 months. Results. The medical treatment policy in this patient sample demonstrates the worst results, with the majority of cardiovascular events developing in the hospital period. PCI in patients with NSTE ACS and multiple coronary atherosclerosis has a number of objective limitations in this patient sample, leading to suboptimal treatment outcomes Conclusion. The use of CABG or PCI as a myocardial revascularization technique in patients with NSTE ACS and MVCAD is characterized by a comparable satisfactory survival in the hospital and long-term follow-up periods. 12% of patients do not receive revascularization due to the extremely high risk from any of coronary blood restoring methods, which results in very many deaths largely occurring during the hospital period.

P6005Incidence and clinical characteristics of coronary artery spasm in patients with out-of-hospital cardiac arrest

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Kawamura ◽  
H Okayama ◽  
S Kido ◽  
T Aono ◽  
K Matsuda ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Coronary Spasm ◽  
Coronary Syndrome ◽  
Organic Heart Disease ◽  
Japanese Guideline ◽  
Hospital Cardiac Arrest

Abstract Background Substantial cases of out-of-hospital cardiac arrest (OHCA) due to acute coronary syndrome have been recognized thus far, but there have been few reports about the aetiology of patients with OHCA without the organic heart disease. Especially, coronary artery spasm would be one of the causes of OHCA. Purpose This study aimed to investigate causes of OHCA without the organic heart disease and to investigate the characteristics and angiographic findings of OHCA patients with vasospastic angina (VSA). Methods Between January 2010 and April 2018, 920 patients with OHCA caused by probable or definite cardiovascular disease were transferred to our hospital. Return of spontaneous contraction was successfully achieved in 151 patients, among whom diagnosis was made in 130 patients. First, we analysed the causes of OHCA in these patients. Second, we compared clinical and angiographic characteristics between the VSA group with OHCA (OHCA-VSA) and the VSA group without OHCA (stable VSA; n=72) from our database. Results Among the 130 patients, 95 (73%) had the organic heart disease; 72, acute coronary syndrome; 19, myocardial disease; 2, valvular heart disease; and 1, congenital heart disease. There were 35 patients (27%) without the organic heart disease. Nineteen patients had primary (i.e., Brugada syndrome, QT prolongation) or secondary arrhythmia (i.e. drug adverse effect). Electrocardiogram, coronary angiogram, and LV structure and function were normal in 35 patients. However, there were 16 patients (11%) with VSA defined by Japanese guideline. The OHCA-VSA group was significantly younger (50±14) than the stable VSA group (64±11, P=0.003). The incidence of diffuse-type spasm in the OHCA-VSA group (100%) was significantly higher than that in the stable VSA group (100% vs. 69%, P<0.05). In addition, the incidence of triple-vessel coronary spasm in the OHCA-VSA group was significantly higher than that in the stable VSA group (86% vs. 25%, P=0.003). Conclusion OHCA patients without the organic heart disease had considerable cases of VSA, in addition to primary or secondary arrhythmia. Furthermore, the severity of spasm in the OHCA-VSA group was more serious and extensive than in comparison with the stable VSA group.

scholarly journals Coronary Artery Spasm as a Frequent Cause of Acute Coronary Syndrome

2008 ◽  
Vol 52 (7) ◽  
pp. 523-527 ◽  
Author(s):  
Peter Ong ◽  
Anastasios Athanasiadis ◽  
Stephan Hill ◽  
Holger Vogelsberg ◽  
Matthias Voehringer ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Coronary Syndrome

scholarly journals Diclofenac Potassium-Induced Anaphylaxis with an Allergic Acute Coronary Syndrome and Premature Ventricular Contractions; Outpatient Clinic Management; A Case Report

2020 ◽  
Vol 01 (01) ◽  
pp. 0013-0016
Author(s):  
Yasser Mohammed Hassanain Elsayed
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Outpatient Clinic ◽  
Anaphylactic Shock ◽  
Heart Diseases ◽  
Coronary Artery Spasm ◽  
Type I ◽  
Drug Induced ◽  
Premature Ventricular Contractions ◽  
Coronary Syndrome

Drug-induced disease is a common clinical entity. Drug-inducing anaphylaxis is a serious adverse effect. Several cases of allergic acute coronary syndrome or Kounis syndrome were reported. Premature ventricular contractions are the most frequent cardiac arrhythmia with or without structural heart diseases. A premature ventricular contraction is a sign of decreased oxygenation to the myocardium and anxiety but is also found in a healthy heart. A middle-aged married male patient presented to the physician outpatient clinic with syncope within one hour after ingested one tablet of diclofenac potassium (50mg). Diclofenac potassium-induced anaphylaxis and Kounis type I syndrome with premature ventricular contractions. Electrocardiography, oxygenation, monitoring for vital signs, and echocardiography were the done interventions. The dramatic disappearance of anaphylactic shock, Kounis type I syndrome, coronary artery spasm, and premature ventricular contractions after the traditional treatment of anaphylaxis had happened. Complete clinical and electrocardiographic recovery had achieved. The identi􀏐ication of drug-induced disease is a pivotal step in the diagnosis decision making of any medical problems. Diclofenac potassium can induce anaphylactic shock, Kounis type I syndrome, coronary artery spasm, and premature ventricular contractions. Kounis type I syndrome, coronary artery spasm, and premature ventricular contractions can be reversed with treatment of the cause without using anti-ischemic or ant-arrhythmic measures. Reassurance was the recommended regards diclofenac potassium-induced both coronary artery spasm and premature ventricular contractions that accompanied by anaphylaxis.

scholarly journals 3-Year Follow-Up of Patients With Coronary Artery Spasm as Cause of Acute Coronary Syndrome

2011 ◽  
Vol 57 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Peter Ong ◽  
Anastasios Athanasiadis ◽  
Gabor Borgulya ◽  
Matthias Voehringer ◽  
Udo Sechtem
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Coronary Syndrome
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