Coronary artery spasm can cause recurrent variant angina with ST-segment elevation.The patient was asymptomatic with normal vitals and ECG was normal.We present a case associated with transient ST-segment elevation an...Coronary artery spasm can cause recurrent variant angina with ST-segment elevation.The patient was asymptomatic with normal vitals and ECG was normal.We present a case associated with transient ST-segment elevation and signifi-cant increase in troponin levels with non-critical lesion with normal CAG.展开更多
The patient was a 71-year-old man who underwent a right hemicolectomy for ascending colon cancer(pT3,pN1,pM0) and who opted not to receive adjuvant chemotherapy.Eight months later,multiple liver metastases occurred.He...The patient was a 71-year-old man who underwent a right hemicolectomy for ascending colon cancer(pT3,pN1,pM0) and who opted not to receive adjuvant chemotherapy.Eight months later,multiple liver metastases occurred.He therefore received FOLFOX4(5-fluorouracil/leucovorin and 85 mg/m 2 oxaliplatin) therapy,up to a total of 5 courses,and showed a partial response.While receiving the sixth course of FOLFOX4,he complained of chest pain and systemic itching approximately 15 min after the start of chemo-therapy.An electrocardiogram revealed typical signs of ischemia.Coronary arteriography showed that the coronary arteries were intact.Believing the chest pain to be merely coincidental,we continued with the same therapy.However,he again developed the same chest pain during the seventh cycle of FOLFOX4 and treatment was stopped.We concluded that the patient's symptoms were due to acute coronary syndrome(ACS) associated with the FOLFOX4 regimen.Variant angina as a type of ACS is a rare adverse effect of FOLFOX4. Clinicians should be aware of this potential adverse effect when monitoring patients receiving FOLFOX4.展开更多
Variant angina, first described by Prinzmetal et a in 1959. is hypothesized to be caused by transient coronary＇ vasospasm at the site of an atherosclerotic plaque and leading to repetitive episodes of transmural myoc...Variant angina, first described by Prinzmetal et a in 1959. is hypothesized to be caused by transient coronary＇ vasospasm at the site of an atherosclerotic plaque and leading to repetitive episodes of transmural myocardial ischemia. Myocardial bridging, a congenital coronary abnormality, is defined as a segment of a major epicardial coronary after, running intramurally through the myocardium.2 The association of variant angina and isolated myocardial bridging is very uncommon. A review of the literature reveals only one case report）ndicating a causal relationship between the two diseases.We present an additional case who experienced Prinzmetal variant angina related to isolated myocardial bridging of the left anterior descending coronary artery （LAD）, which was evaluated with intravascular ultrasound and quantitative coronary angiography.展开更多
BACKGROUND Patients with vasospastic angina(VSA)sometimes experience prolonged chest symptoms.The clinical characteristics of these patients have not been clarified.AIM To investigate the clinical characteristics of p...BACKGROUND Patients with vasospastic angina(VSA)sometimes experience prolonged chest symptoms.The clinical characteristics of these patients have not been clarified.AIM To investigate the clinical characteristics of prolonged VSA patients.METHODS This study included 167 patients with VSA diagnosed by spasm provocation tests(SPTs)using acetylcholine,which recorded the frequencies of positive reactions to a low dose of acetylcholine(L-ACh),total occlusion due to spasm(TOC),focal spasm,and the unavoidable use of nitroglycerin(unavoidable-NTG)during SPTs.The patients underwent a medical interview that investigated the maximum duration and frequency of chest symptoms as well as the frequencies of variant angina and other serious symptoms.The patients were divided into two groups based on the maximal duration:The short-duration group(<15 min;n=114)and the long-duration group(≥15 min;n=53).They were also divided into two groups based on the frequency of chest symptoms:The low-frequency group(<4/mo;n=88)and the high-frequency group(≥4/mo;n=79).RESULTS The long-duration group showed higher frequencies of other serious symptoms(P<0.001)and variant angina(P<0.05)as well as higher frequencies of spasm induction by L-ACh(P<0.05),TOC(P<0.05),focal spasm(P<0.01),and unavoidable-NTG(P<0.01)than the short-duration group.These parameters did not differ significantly between the low-frequency and high-frequency groups.CONCLUSION These findings suggest that patients with VSA who experience prolonged chest symptoms may have more severe characteristics of VSA.展开更多
研究变异性心绞痛患者 ST 段抬高对心率变异性的影响。回顾性分析122例变异性心绞痛患者 ST 段抬高幅度及持续时间对心率变异性的影响；心率变异性与冠状动脉病变及病变支数、狭窄程度有相关性。结果心率变异性在 ST 段抬高≥0．4mv 患...研究变异性心绞痛患者 ST 段抬高对心率变异性的影响。回顾性分析122例变异性心绞痛患者 ST 段抬高幅度及持续时间对心率变异性的影响；心率变异性与冠状动脉病变及病变支数、狭窄程度有相关性。结果心率变异性在 ST 段抬高≥0．4mv 患者中较 ST 段抬高＜0．4mv 患者中明显降低（P＜0．05）；其在 ST 段抬高持续时间≥3min 患者中较 ST 段抬高持续时间＜3min 患者中明显降低（P＜0．05）；其在冠状动脉狭窄≥50％患者中较冠状动脉狭窄＜50％患者中明显降低（P＜0．05）；心率变异性在多支较单支病变明显降低（P ＜0．05），单支病变狭窄程度≥75％较50％～75％者明显降低（P＜0．05）。提示变异性心绞痛患者自主神经系统受损程度与冠状动脉缺血严重程度，缺血持续时间密切相关，心率变异性能一定程度反映变异性心绞痛患者冠状动脉病变严重程度。展开更多
基金the Natural Science Foundation of Shandong Province(ZR2017BH114)the National Natural Science Foundation of China(81700334)Jinan Science and Technology Plan Project(201805058).
文摘Coronary artery spasm can cause recurrent variant angina with ST-segment elevation.The patient was asymptomatic with normal vitals and ECG was normal.We present a case associated with transient ST-segment elevation and signifi-cant increase in troponin levels with non-critical lesion with normal CAG.
文摘The patient was a 71-year-old man who underwent a right hemicolectomy for ascending colon cancer(pT3,pN1,pM0) and who opted not to receive adjuvant chemotherapy.Eight months later,multiple liver metastases occurred.He therefore received FOLFOX4(5-fluorouracil/leucovorin and 85 mg/m 2 oxaliplatin) therapy,up to a total of 5 courses,and showed a partial response.While receiving the sixth course of FOLFOX4,he complained of chest pain and systemic itching approximately 15 min after the start of chemo-therapy.An electrocardiogram revealed typical signs of ischemia.Coronary arteriography showed that the coronary arteries were intact.Believing the chest pain to be merely coincidental,we continued with the same therapy.However,he again developed the same chest pain during the seventh cycle of FOLFOX4 and treatment was stopped.We concluded that the patient's symptoms were due to acute coronary syndrome(ACS) associated with the FOLFOX4 regimen.Variant angina as a type of ACS is a rare adverse effect of FOLFOX4. Clinicians should be aware of this potential adverse effect when monitoring patients receiving FOLFOX4.
文摘Variant angina, first described by Prinzmetal et a in 1959. is hypothesized to be caused by transient coronary＇ vasospasm at the site of an atherosclerotic plaque and leading to repetitive episodes of transmural myocardial ischemia. Myocardial bridging, a congenital coronary abnormality, is defined as a segment of a major epicardial coronary after, running intramurally through the myocardium.2 The association of variant angina and isolated myocardial bridging is very uncommon. A review of the literature reveals only one case report）ndicating a causal relationship between the two diseases.We present an additional case who experienced Prinzmetal variant angina related to isolated myocardial bridging of the left anterior descending coronary artery （LAD）, which was evaluated with intravascular ultrasound and quantitative coronary angiography.
文摘BACKGROUND Patients with vasospastic angina(VSA)sometimes experience prolonged chest symptoms.The clinical characteristics of these patients have not been clarified.AIM To investigate the clinical characteristics of prolonged VSA patients.METHODS This study included 167 patients with VSA diagnosed by spasm provocation tests(SPTs)using acetylcholine,which recorded the frequencies of positive reactions to a low dose of acetylcholine(L-ACh),total occlusion due to spasm(TOC),focal spasm,and the unavoidable use of nitroglycerin(unavoidable-NTG)during SPTs.The patients underwent a medical interview that investigated the maximum duration and frequency of chest symptoms as well as the frequencies of variant angina and other serious symptoms.The patients were divided into two groups based on the maximal duration:The short-duration group(<15 min;n=114)and the long-duration group(≥15 min;n=53).They were also divided into two groups based on the frequency of chest symptoms:The low-frequency group(<4/mo;n=88)and the high-frequency group(≥4/mo;n=79).RESULTS The long-duration group showed higher frequencies of other serious symptoms(P<0.001)and variant angina(P<0.05)as well as higher frequencies of spasm induction by L-ACh(P<0.05),TOC(P<0.05),focal spasm(P<0.01),and unavoidable-NTG(P<0.01)than the short-duration group.These parameters did not differ significantly between the low-frequency and high-frequency groups.CONCLUSION These findings suggest that patients with VSA who experience prolonged chest symptoms may have more severe characteristics of VSA.
文摘研究变异性心绞痛患者 ST 段抬高对心率变异性的影响。回顾性分析122例变异性心绞痛患者 ST 段抬高幅度及持续时间对心率变异性的影响；心率变异性与冠状动脉病变及病变支数、狭窄程度有相关性。结果心率变异性在 ST 段抬高≥0．4mv 患者中较 ST 段抬高＜0．4mv 患者中明显降低（P＜0．05）；其在 ST 段抬高持续时间≥3min 患者中较 ST 段抬高持续时间＜3min 患者中明显降低（P＜0．05）；其在冠状动脉狭窄≥50％患者中较冠状动脉狭窄＜50％患者中明显降低（P＜0．05）；心率变异性在多支较单支病变明显降低（P ＜0．05），单支病变狭窄程度≥75％较50％～75％者明显降低（P＜0．05）。提示变异性心绞痛患者自主神经系统受损程度与冠状动脉缺血严重程度，缺血持续时间密切相关，心率变异性能一定程度反映变异性心绞痛患者冠状动脉病变严重程度。
