Akinomi Thyrotoxicosis-Induced Vasospastic Angina The episodes of angina at rest were uncontrollable until diagnosis and proper treatment of the concomitant hyperthyroidism, the onset of which was nearly asymptomatic. Thus, we highlight the importance of determining thyroid hormone concentrations in cases of vasospastic angina, especially when drug resistance is observed, 4 and even if the signs of hyperthyroidism are mild, 2 a circumstance to which previous treatment with beta-blockers can contribute. Si continua navegando, consideramos que acepta su uso. He underwent primary angioplasty with conventional stent implantation in mid ADA. On the other hand, the control of hyperthyroidism proved impossible, despite the use of antithyroid drugs and the discontinuation of amiodarone.
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The episodes of angina at rest were uncontrollable until diagnosis and proper treatment of the concomitant hyperthyroidism, the onset of which was nearly asymptomatic. Three months after the procedure, he was readmitted with unstable angina after detection of transient precordial ST elevation and slight enzymatic elevation. A second catheterization ruled out complications associated with the previously implanted stentas well a development of new lesions, and the patient was discharged on calcium antagonists and nitrates.
The atenolol that had originally been prescribed was discontinued. You can change the settings or obtain more information by clicking here. Print Send to a friend Export reference Mendeley Statistics. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. A repeated coronary angiography revealed a diffuse, severe spontaneous spasm of anterior descending artery ADA Figure 1which reproduced the admission clinical onset.
Subscriber If you already have your login data, please click here. Subscribe to our Newsletter. Continuing navigation will be considered as acceptance of this use. The free thyroxine level was 6. Thyrotoxicosis-Induced Vasospastic Angina This item has received. CiteScore measures average citations received per document published. These manuscripts contain updated topics with a major clinical or conceptual relevance in modern medicine.
Previous article Next article. Se continuar a navegar, consideramos que aceita o seu uso. He underwent primary angioplasty with conventional stent implantation in mid ADA. The duration of the follow-up period was 14 months. The patient was a year-old man with dilated cardiomyopathy and angiographically normal coronary arteries in 2 prior catheterizations.
Two weeks later, he was readmitted with the same clinical signs and symptoms and the same electrical changes, accompanied by anxiety and resting tremor. September Pages Thus, we highlight the importance of determining thyroid hormone concentrations in cases of vasospastic angina, especially when drug resistance is observed, 4 and even if the signs of hyperthyroidism are mild, 2 a circumstance to which previous treatment with dee can contribute.
Calls from Spain 88 87 40 9 to 18 hours. Images subject to Copyright. Si continua navegando, consideramos que acepta su uso. The journal adheres to the standards of academic research publications in all aspects including peer-review and ethical principles. Are you a health professional fisippatologia to prescribe or dispense drugs? Forty-eight hours later, a level of free thyroxine of 4. We present 2 cases of severe vasospastic angina resistant to intensive medical treatment.
From Monday to Friday from 9 a. EMC VNXE PDF The main characteristic of the initial clinical course was the difficult management, with frequent anginal episodes, despite the use of high-dose calcium antagonists and nitrates. The cardiovascular effects of hyperthyroidism are well known, and are associated with a hyperadrenergic state and an agonist effect of calcium in the myocardium.
Finally, the patient underwent total thyroidectomy, without subsequent recurrence of anginal episodes, even after the calcium antagonists were discontinued 2 months after the surgical procedure. Once the diagnosis of hyperthyroidism is established, medical treatment usually suffices, although, in gisiopatologia cases, most of which are induced by amiodarone, thyroidectomy may be necessary.
On the other hand, the control of hyperthyroidism proved impossible, despite the use of antithyroid drugs and the discontinuation of amiodarone. December Next article.
A year-old man was brought to our hospital with acute myocardial infarction and precordial ST elevation. Hospital General Universitario de Alicante.
Previous Article Vol This time, coronary angiography revealed diffuse spasm in mid-distal ADA Figure 2which was controlled with intracoronary nitroglycerin. The authors wish to thank the reviewers for their comments and the suggested prinz,etal, which contributed considerably to improving the manuscript.
For the management of this entity, it is essential to control the thyroid activity, which can be curative in itself, obviating the need for subsequent antianginal therapy, 5 especially if there is no accompanying fisuopatologia disease. TOP Related Articles.
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