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Rare Clinical Manifestation of Vasculitis.
Diagnostics (Basel)
November 2024
Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Article Synopsis
- ANCA-associated vasculitis is linked to a significantly higher risk of cardiovascular issues, with rare but serious coronary artery involvement.
- A 68-year-old woman with p-ANCA vasculitis and severe kidney disease presented with chest pain and low blood pressure, showing signs of coronary vasospasm rather than blockage during testing.
- Treatment with medications such as amlodipine and corticosteroids successfully resolved her symptoms, highlighting the immune-mediated nature of the vascular inflammation.
Factors Contributing to Coronary Microvascular Dysfunction in Patients with Angina and Non-Obstructive Coronary Artery Disease.
J Cardiovasc Dev Dis
July 2024
Department of Cardiovascular Medicine, JR Hiroshima Hospital, 3-1-36, Futabanosato, Higashi-Ku, Hiroshima 732-0057, Japan.
Background: Coronary microvascular dysfunction (CMD), characterised by a reduced coronary flow reserve (CFR) or an increased index of microcirculatory resistance (IMR), has received considerable attention as a cause of chest pain in recent years. However, the risks and causes of CMD remain unclear; therefore, effective treatment strategies have not yet been established. Heart failure or coronary artery disease (CAD) is a risk factor for CMD, with a higher prevalence among women.
View Article and Find Full Text PDFClinical Limitations of Vasoreactivity Testing as a Diagnostic Tool in Patients with Vasospastic Angina.
Intern Med
May 2024
Department of Cardiology, Minami Matsuyama Hospital, Japan.
The Japanese Circulation Society guidelines recommend a class I vasoreactivity test to diagnose patients with vasospastic angina (VSA). However, the acetylcholine or ergonovine test has been established as the gold standard for variant angina (VA). The sensitivity and specificity of intracoronary vasoreactivity testing in patients with VA were acceptable.
View Article and Find Full Text PDFElevated white blood cell count and long-term clinical outcomes of patients with vasospastic angina.
Coron Artery Dis
August 2024
Division of Cardiology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
Article Synopsis
- The study investigates the link between white blood cell (WBC) count and long-term health outcomes in patients diagnosed with vasospastic angina (VA), a condition related to coronary artery disease.
- A total of 823 VA patients without significant coronary lesions were analyzed over an average follow-up period of 4.3 years, dividing them into two groups based on their WBC counts at diagnosis.
- Results showed no major differences in overall adverse events between groups; however, higher WBC counts were linked to increased risks of cardiac death and myocardial infarction (MI), with elevated WBC being an independent predictor for MI.
Safety and potential usefulness of sequential intracoronary acetylcholine and ergonovine administration for spasm provocation testing.
Ther Adv Cardiovasc Dis
February 2024
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Background: Although guidelines recommend intracoronary acetylcholine (ACh) and ergonovine (ER) provocation testing for diagnosis of vasospastic angina, the feasibility and safety of sequential (combined) use of both pharmacological agents during the same catheterization session remain unclear.
Objectives: In this study, we investigated the feasibility and safety of sequential intracoronary ACh and ER administration for coronary spasm provocation testing.
Methods: The study included 235 patients who showed positive results on ACh and ER provocation testing.
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