Background: Coronary vasospasm is an increasingly recognized cause of myocardial infarction or myocardial ischaemia in patients without obstructive coronary artery disease. A thorough medication review may identify drugs or toxins that could trigger coronary vasospasm. This case provides mechanistic insight into the off-target effect of proteasome inhibition leading to coronary vasospasm in a patient referred with chest pain consistent with typical angina.
Case Summary: A 72-year-old lady presented with anginal chest pain at rest with electrocardiogram evidence of myocardial ischaemia who was referred for invasive coronary angiography. This demonstrated minor coronary disease without an obstructive lesion. Vasoreactivity testing revealed diffuse coronary vasospasm of the left anterior descending artery. Carfilzomib was identified as the trigger for coronary vasospasm. Symptoms resolved without recurrence after appropriate treatment including cessation of the triggering agent.
Conclusion: Coronary spasm is a rare but important adverse reaction to proteasome inhibitors. This case supports the clinical utility of invasive coronary vasoreactivity testing in patients with ischaemia with no obstructive coronary artery disease.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8323061 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytab076 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
When the heart deceives: a case report of hyperthyroidism disguised as STEMI in female pregnant patient.
Egypt Heart J
January 2025
Department of Cardiology and Vascular Medicine, Rumah Sakit Umum Daerah Gunung Jati, Kesambi Street No. 56, Cirebon, West Java, 45134, Indonesia.
Background: Acute myocardial infarction during pregnancy is a rare condition with an incidence of 1 to 10 per 100,000 deliveries. ST-elevation myocardial infarction (STEMI) is dominating the clinical presentation. It is estimated that 29% of the patients had normal coronary arteries, and hyperthyroidism may be associated with coronary vasospasm.
View Article and Find Full Text PDFDiffuse Coronary Vasospasm After Zone 2 Debranching and Antegrade TEVAR.
Ann Thorac Surg Short Rep
December 2024
Division of Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, Florida.
Coronary vasospasm involves constriction of the coronary arteries and has been described after manipulation of the coronary arteries (ie, after stenting or bypass grafting). This report details the case of a 57-year-old man who presented with an endoleak after thoracic endovascular aortic repair. He underwent a frozen elephant trunk procedure and postoperatively had diffuse coronary vasospasm, demonstrated on pre- and post-vasospasm cardiac catheterization.
View Article and Find Full Text PDFThe comparative efficacy and safety of Tiger II versus judkins catheters in coronary angiogram via the radial artery access: a meta-analysis.
Acta Cardiol
January 2025
Department of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA.
Background: Trans-radial coronary angiogram (TR-CAG) has gained popularity due to lower complication rates compared to transfemoral access. Operators can use either conventional catheters, such as Judkins, or single dedicated catheters, such as Tiger-II. This meta-analysis compared the safety and efficacy of Tiger-II versus Judkins catheters in TR-CAG.
View Article and Find Full Text PDFHow to Use Imaging: Complex Cases of Atherosclerosis, Myocardial Inflammation, and Cardiomyopathy in Cardio-Oncology.
Circ Cardiovasc Imaging
January 2025
Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (M.K., M.B., T.E.Z., L.A.B.).
It is well understood that cancer therapies including chemotherapy, tyrosine kinase inhibitors, immune checkpoint inhibitors, and radiation can increase the risk of cardiovascular disease in patients with cancer. This can manifest as a multitude of pathologies including left ventricular dysfunction, myocarditis, cardiomyopathy, accelerated atherosclerosis, and coronary vasospasm. Multimodal cardiac imaging plays a critical role in diagnosing such pathologies by relying on noninvasive tools including echocardiograms, cardiac magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, and coronary computed tomography angiography.
View Article and Find Full Text PDFComment on: "Cardiac arrest due to coronary vasospasm after sugammadex administration-a case report".
Korean J Anesthesiol
January 2025
Division of Neuroanaesthesiology, International Institute of Neurosciences, Aster Whitefield Hospital, Bengaluru, Karnataka, India.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!