Postpartum Coronary Vasospasm with Literature Review

Koneru, Jayanth; Cholankeril, Matthew; Patel, Kunal; Alattar, Fadi; Alqaqa, Ashraf; Virk, Hirtaj; Shamoon, Fayez; Bikkina, Mahesh

doi:10.1155/2014/523023

Cited by 10 publications

(6 citation statements)

References 46 publications

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“…Moreover, some iatrogenic factors such as catheterisation and pericardial manipulation were also identified as a risk for vasospasm in epicardial vessels. 40 Smoking has the strongest correlation with vasospastic angina, even more than its association with atherosclerotic coronary artery disease. 24 In addition to tobacco smoking, marijuana/weed smoke inhalation has also been found to be a contributory factor in the development of vasospastic angina which may lead to myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

“…Other factors that can lead to the vasospastic angina during pregnancy or in postpartum period include the elevation in the level of renin angiotensin from uterine hypo perfusion and endothelial function impairment. 40 In light of the recent increase in the consumption of such substances, especially by young adults, it is imperative that further trials should be conducted about their possible role in the pathophysiology of vasospastic angina. In cases of non-occlusive ischemic chest pain, a thorough history taking should be encouraged among medical practitioners.…”

Section: Discussionmentioning

confidence: 99%

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Modifiable risk factors of vasospastic angina: a systematic literature review

Albalawi

Alotaibi

Alharbi

et al. 2021

Int J Community Med Public Health

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Vasospastic angina is caused by transient coronary spasms unrelated to exertion, which may even occur at rest (classically at night) and promptly responds to short acting nitrates. It is thought to be caused by inherent generalised hyper reactivity of the smooth muscle cells of epicardial vessels to various stimuli. Being comparatively less studied, the risk factors for VSA vary considerably from obstructive or atherosclerotic cardiac disease. However, coronary vasospasm can occur in non stenosed arteries, atherosclerotic arteries as well as sub critically stenosed arteries which can result in significant overlap between the risk factors and underlying pathophysiology. 1-14% of AMI can be caused by non-obstructive, or ‘functional’ coronary artery disorders like vasospastic angina but VSA continues to be underdiagnosed and less well understood than obstructive coronary artery disorders. This prompted us to study the existing literature for modifiable risk factors of coronary artery vasospasm so that an emphasis can be made on proper lifestyle modifications and avoidance of vasospastic agents in susceptible individuals. Smoking proved to be the most important risk factor whereas recreational drugs and drugs used for treatment of certain medical disorders have also been shown to associate with coronary vasospasm. Medical personnel, therefore, need to be more vigilant in history taking as well as investigating cardiac chest pain in which traditional investigations end up being normal so that an early diagnosis of vasospastic angina can be made and appropriate steps taken to improve the quality of life of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Modifiable risk factors of vasospastic angina: a systematic literature review

Albalawi

Alotaibi

Alharbi

et al. 2021

Int J Community Med Public Health

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“…50 It is estimated that vasospasm accounts for around 2% of pregnant patients presenting with AMI or angina. 51 The pathophysiological mechanisms are unclear, but may be related to enhanced vascular reactivity, increased renin release, and endothelial dysfunction in pregnancy. Prolonged vasospasm may also predispose to coronary thrombus formation.…”

Section: Coronary Vasospasmmentioning

confidence: 99%

Coronary Events in the Pregnant Patient: Who Is at Risk and How Best to Manage?

Samuel

Alfadhel

McAlister

et al. 2021

Canadian Journal of Cardiology

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“…This dilation is mediated through the conversion of nitrate to nitric oxide (NO) in the body, activation of soluble guanylate cyclase (sGC), and subsequent increase in cGMP [2]. In the clinical setting, however, there are cases where a patient is refractory to treatment with organic nitrates [3,4,5]. This phenomenon cannot be explained just by the phenomenon of nitrate tolerance [6].…”

Section: Introductionmentioning

confidence: 99%

Responsiveness of Coronary Arteries to Nitroglycerin under Hypoxia: The Importance of the Endothelium

Tawa

Shimosato²,

Saito³

et al. 2017

Pharmacology

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Background/Aims: Nitroglycerin is widely used as a coronary vasodilator in the treatment of ischemic heart diseases. This study investigated the influence of hypoxia on nitroglycerin-induced relaxation in endothelium-intact and -denuded rabbit, monkey, and porcine coronary arteries. Methods: Helically cut strips of coronary arteries were suspended in organ chambers, and isometric tension was recorded. Results: Nitroglycerin concentration dependently relaxed endothelium-intact rabbit coronary arteries, which were not different under normoxic and hypoxic conditions. On the other hand, nitroglycerin-induced relaxation of endothelium-denuded arteries was significantly attenuated by hypoxia. Similarly, the relaxant response of endothelium-intact monkey coronary arteries to nitroglycerin was not affected by hypoxia, whereas that of endothelium-denuded arteries was impaired. As is the case with rabbit and monkey coronary arteries, exposure to hypoxia resulted in impaired relaxation by nitroglycerin in endothelium-denuded but not endothelium-intact porcine coronary arteries. Conclusion: These findings suggest that coronary endothelium plays a pivotal role in preventing the hypoxia-induced impairment of nitroglycerin responsiveness, regardless of the animal species.

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Postpartum Coronary Vasospasm with Literature Review

Cited by 10 publications

References 46 publications

Modifiable risk factors of vasospastic angina: a systematic literature review

Modifiable risk factors of vasospastic angina: a systematic literature review

Coronary Events in the Pregnant Patient: Who Is at Risk and How Best to Manage?

Responsiveness of Coronary Arteries to Nitroglycerin under Hypoxia: The Importance of the Endothelium

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