Vasospastic angina followed by acute coronary syndrome and myocardial infarction: a case report
Introduction. One of the angina causes in intact coronary arteries may be vasospasm. Despite the stenosis absence, vasospastic angina is characterized by a recurrent course, can progress to myocardial infarction (MI) and cause life-threatening arrhythmias.Short description. A case of vasospastic ang...
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«SILICEA-POLIGRAF» LLC
2024-05-01
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| Series: | Кардиоваскулярная терапия и профилактика |
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| Online Access: | https://cardiovascular.elpub.ru/jour/article/view/3951 |
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| author | S. A. Chepurnenko G. V. Shavkuta M. S. Chepurnenko |
| author_facet | S. A. Chepurnenko G. V. Shavkuta M. S. Chepurnenko |
| author_sort | S. A. Chepurnenko |
| collection | DOAJ |
| description | Introduction. One of the angina causes in intact coronary arteries may be vasospasm. Despite the stenosis absence, vasospastic angina is characterized by a recurrent course, can progress to myocardial infarction (MI) and cause life-threatening arrhythmias.Short description. A case of vasospastic angina in a 69-year-old man, confirmed by 24-hour electrocardiographic monitoring, is presented. Long-term vasospasm first led to acute coronary syndrome on November 11, 2022 without myocardial damage. Standard therapy is recommended. Calcium antagonists were not included in the prescriptions. Then, on December 23, 2022, frequent and longer-lasting attacks of angina with extensive irradiation and shortness of breath appeared. On December 29, 2022, acute MI developed. Both cardiovascular events were caused by vasospasm in the right coronary artery.Discussion. Currently, there is no exact data the frequency of vasospastic angina in Russia. There are no definitive guidelines regarding the rationale of endovascular intervention. High doses of calcium channel blockers are usually suggested. In case of insufficient effect of monotherapy, dihydropyridine and non-dihydropyridine calcium antagonists simultaneously or add long-acting nitrates should be used. Nicorandil is used as second-line drugs. The positive effect of statins has been proven. However, complete solution of the problem of recurrent MI against the background of vasospasm was not possible. The presented case highlights the recurrent nature of the disease and the importance of selecting optimal therapy aimed at preventing vasospasm in order to reduce the risk of myocardial damage in this category of patients. |
| format | Article |
| id | doaj-art-898368fc523c42719b9c538c441a3ca9 |
| institution | Kabale University |
| issn | 1728-8800 2619-0125 |
| language | Russian |
| publishDate | 2024-05-01 |
| publisher | «SILICEA-POLIGRAF» LLC |
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| series | Кардиоваскулярная терапия и профилактика |
| spelling | doaj-art-898368fc523c42719b9c538c441a3ca92025-08-20T03:35:51Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252024-05-0123410.15829/1728-8800-2024-39512954Vasospastic angina followed by acute coronary syndrome and myocardial infarction: a case reportS. A. Chepurnenko0G. V. Shavkuta1M. S. Chepurnenko2Rostov State Medical University; Rostov Regional Clinical HospitalRostov State Medical UniversityRostov State Medical UniversityIntroduction. One of the angina causes in intact coronary arteries may be vasospasm. Despite the stenosis absence, vasospastic angina is characterized by a recurrent course, can progress to myocardial infarction (MI) and cause life-threatening arrhythmias.Short description. A case of vasospastic angina in a 69-year-old man, confirmed by 24-hour electrocardiographic monitoring, is presented. Long-term vasospasm first led to acute coronary syndrome on November 11, 2022 without myocardial damage. Standard therapy is recommended. Calcium antagonists were not included in the prescriptions. Then, on December 23, 2022, frequent and longer-lasting attacks of angina with extensive irradiation and shortness of breath appeared. On December 29, 2022, acute MI developed. Both cardiovascular events were caused by vasospasm in the right coronary artery.Discussion. Currently, there is no exact data the frequency of vasospastic angina in Russia. There are no definitive guidelines regarding the rationale of endovascular intervention. High doses of calcium channel blockers are usually suggested. In case of insufficient effect of monotherapy, dihydropyridine and non-dihydropyridine calcium antagonists simultaneously or add long-acting nitrates should be used. Nicorandil is used as second-line drugs. The positive effect of statins has been proven. However, complete solution of the problem of recurrent MI against the background of vasospasm was not possible. The presented case highlights the recurrent nature of the disease and the importance of selecting optimal therapy aimed at preventing vasospasm in order to reduce the risk of myocardial damage in this category of patients.https://cardiovascular.elpub.ru/jour/article/view/3951type 2 myocardial infarctionvasospastic anginaacute coronary syndromepercutaneous coronary interventionintact coronary arteries |
| spellingShingle | S. A. Chepurnenko G. V. Shavkuta M. S. Chepurnenko Vasospastic angina followed by acute coronary syndrome and myocardial infarction: a case report Кардиоваскулярная терапия и профилактика type 2 myocardial infarction vasospastic angina acute coronary syndrome percutaneous coronary intervention intact coronary arteries |
| title | Vasospastic angina followed by acute coronary syndrome and myocardial infarction: a case report |
| title_full | Vasospastic angina followed by acute coronary syndrome and myocardial infarction: a case report |
| title_fullStr | Vasospastic angina followed by acute coronary syndrome and myocardial infarction: a case report |
| title_full_unstemmed | Vasospastic angina followed by acute coronary syndrome and myocardial infarction: a case report |
| title_short | Vasospastic angina followed by acute coronary syndrome and myocardial infarction: a case report |
| title_sort | vasospastic angina followed by acute coronary syndrome and myocardial infarction a case report |
| topic | type 2 myocardial infarction vasospastic angina acute coronary syndrome percutaneous coronary intervention intact coronary arteries |
| url | https://cardiovascular.elpub.ru/jour/article/view/3951 |
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