Coronary Artery Spasm: A Review

Richmond, David

doi:10.1177/014107688007300807

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…For rituximab, an acute coronary syndrome with ST segment elevations in the inferior leads and elevated troponin I is described. The patient suffered from 2-vessel coronary artery disease and was treated with PCI and implantation of 2 drug-eluting stents following left heart catheterization [6]. In contrast, after systemic chemotherapy with intravenous 5-FU, a 64-year-old male patient developed typical angina pectoris with ST segment elevations in V1-V4 but without any increase in cardiac enzymes, as reported by Spencker et al [9].…”

Section: Discussionmentioning

confidence: 62%

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Oxaliplatin-Induced Acute ST Segment Elevation Mimicking Myocardial Infarction: A Case Report

et al. 2018

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Background: Oxaliplatin is a platinum-based antineoplastic agent used for the treatment of colorectal cancer and other gastrointestinal tumors. In combination with 5-fluorouracil for instance it is given in the so-called FOLFOX regimen in patients with colorectal cancer in the adjuvant as well as the palliative treatment setting. Cumulative neuropathy is a common cause of treatment discontinuation. Other toxicities are generally tolerable and managed by dose reductions and/or supportive treatment. While chronic cardiotoxic effects of cytostatics are well described, there are few reports on acute cardiotoxic reactions. Case Report: The present case describes the sudden development of a transient coronary vasospasm in a 56-year-old male patient mimicking an acute ST segment elevation myocardial infarction during systemic treatment with oxaliplatin. Conclusion: Oxaliplatin is one of the most commonly used cytostatics for gastrointestinal cancer. Coronary vasospasm has never been reported for oxaliplatin. Thus it is crucial to keep in mind that acute cardiotoxic side effects may occur, even with chemotherapeutic agents without a prior evidence-based description of such events.

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Section: Discussionmentioning

confidence: 62%

“…It is crucial to be aware of these potential cardiotoxic reactions, even though they may be rarely observed. Patients with coronary artery spasm are at risk of ventricular arrhythmias and sudden cardiac death [6].…”

Section: Introductionmentioning

confidence: 99%

Oxaliplatin-Induced Acute ST Segment Elevation Mimicking Myocardial Infarction: A Case Report

et al. 2018

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“…This case report, however, raises the possibility of an interaction between such voltage-gated Na + channels. This appears to be the first report of oxaliplatin-induced acute coronary spasms, also known as Princemetal angina8 or atypical angina 9. Osler introduced the concept of coronary spasms in 191010 and nowadays it is well recognised that although ST-segment elevation is a common finding during spasm, ST-segment depression and T-wave changes may also be observed during ischaemic episodes 9.…”

Section: Discussionmentioning

confidence: 89%

Oxaliplatin-induced coronary artery spasm: first report of an important side-effect

Samol

Waterston²

2009

Case Reports

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“…Although STE is a common finding during spasm, ST-segment depression and T-wave changes may also be observed during different ischaemic episodes in the same patient. These latter changes reflect lesser degrees of ischaemia suggesting varying severity of spasm at the same site or varying extent of involvement of the coronary artery tree by spasm 31,32 . The spasms are most commonly focal and can occur simultaneously in more than one site.…”

Section: Prinzmetal Anginamentioning

confidence: 99%

ST Segment Elevation Besides Acute Myocardial Infarction

Alam

Ara²,

Rahaman

et al. 2012

Univ. Heart J.

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Normal variant of ST segment elevationSTE is commonly observed in the electrocardiogram of normal persons (figure 1). A study done on 45 normal volunteers suggest that standard precordial leads do not accurately predict maximal torso potentials during the ST segment, thus STE may commonly be seen without acute myocardial infarction 3 . Another study conducted on 6014 healthy men in the U.S. Air Force who were 16 to 58 years old, 91% had STE of 1-3 mm in one or more precordial leads 4 . Other study by Surawicz and Parikh on 529 males and 544 females, age 5 to 96 years, showed variation of STE between normal male and female that is, prevalence of STE of at least 1 mm in one or more of leads V 1 through V 4 was 93% in the men who were 17 to 24 years old 5 . According to these studies, it is now established that the main feature of the male pattern in electrocardiograms (ECG) is ST elevation at the J-point of =0.1 mV in at least one of the leads V1-V4 with concave upward ST-segments and the prevalence of the male pattern in ECG of healthy male (mostly Caucasians or Blacks) who were 16-58 years old was high (85%) 4,5 . Much higher prevalence was observed in a recent study in Hong Kong (on 202 apparently healthy Chinese adult males, aged 20-54 years) which was 95.5% 6 . Early repolarization syndromeThe early repolarization syndrome (ERS) is a common electrocardiographic variant characterized by J-point elevation manifested either as QRS slurring (at the transition from the QRS segment to the ST segment) or notching (a positive defection inscribed on terminal S wave), STE with upper concavity and prominent T waves in at least 2 contiguous leads 7-10 . In most of the studies elevation of the J point and/or ST-segment from the baseline by at least 0.1 mV was considered definitive of ER 9,11 (figure 2).ERS is found in approximately 1% to 2% of the young adult population and in up to 13% to 48% of patients presenting with chest pain in the emergency rooms and coronary care units. It generally occurs in the absence of myocardial disease 12,13 . Its predominance is in young black males and shows disproportionate infrequency in white females 14 . This syndrome is common in people under the age of 30 years old and shows decreasing incidence with ST Segment Elevation Besides

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Coronary Artery Spasm: A Review

Cited by 9 publications

References 30 publications

Oxaliplatin-Induced Acute ST Segment Elevation Mimicking Myocardial Infarction: A Case Report

Oxaliplatin-Induced Acute ST Segment Elevation Mimicking Myocardial Infarction: A Case Report

Oxaliplatin-induced coronary artery spasm: first report of an important side-effect

ST Segment Elevation Besides Acute Myocardial Infarction

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