Abstract
A woman with Prinzmetal's variant angina had spontaneous attacks of myocardial ischemia characterized by severe chest pain, hypotension, inferior ST-segment elevation, transient complete heart block and selective right ventricular dysfunction. Despite initial improvement following intravenous administration of atropine and sublingual administration of nitroglycerin she died of cardiogenic shock. Autopsy showed normal coronary arteries and acute pericarditis, more pronounced over the right side of the heart. It is postulated that the pericardial inflammation elicited severe spasm of the subjacent right coronary artery.
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- Dhurandhar R. W., Watt D. L., Silver M. D., Trimble A. S., Adelman A. G. Prinzmetal's variant form of angina with arteriographic evidence of coronary arterial spasm. Am J Cardiol. 1972 Dec;30(8):902–905. doi: 10.1016/0002-9149(72)90018-5. [DOI] [PubMed] [Google Scholar]
- Endo M., Hirosawa K., Kaneko N., Hase K., Inoue Y. Prinzmetal's variant angina. Coronary arteriogram and left ventriculogram during angina attack induced by methacholine. N Engl J Med. 1976 Jan 29;294(5):252–255. doi: 10.1056/NEJM197601292940505. [DOI] [PubMed] [Google Scholar]
- Endo M., Kanda I., Hosoda S., Hayashi H., Hirosawa K., Konno S. Prinzmetal's variant form of angina pectoris. Re-evaluation of mechanisms. Circulation. 1975 Jul;52(1):33–37. doi: 10.1161/01.cir.52.1.33. [DOI] [PubMed] [Google Scholar]
- Hamlin N. P., Willerson J. T., Garan H., Powell W. J., Jr The neurogenic vasoconstrictor effect of digitalis on coronary vascular resistance. J Clin Invest. 1974 Jan;53(1):288–296. doi: 10.1172/JCI107549. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PRINZMETAL M., KENNAMER R., MERLISS R., WADA T., BOR N. Angina pectoris. I. A variant form of angina pectoris; preliminary report. Am J Med. 1959 Sep;27:375–388. doi: 10.1016/0002-9343(59)90003-8. [DOI] [PubMed] [Google Scholar]
- Selzer A., Langston M., Ruggeroli C., Cohn K. Clinical syndrome of variant angina with normal coronary arteriogram. N Engl J Med. 1976 Dec 9;295(24):1343–1347. doi: 10.1056/NEJM197612092952403. [DOI] [PubMed] [Google Scholar]
- Yasue H., Touyama M., Shimamoto M., Kato H., Tanaka S. Role of autonomic nervous system in the pathogenesis of Prinzmetal's variant form of angina. Circulation. 1974 Sep;50(3):534–539. doi: 10.1161/01.cir.50.3.534. [DOI] [PubMed] [Google Scholar]