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. 2009 Feb 3;20(7):656–658. doi: 10.1002/clc.4960200713

Vasospastic angina induced by nonsteroidal anti‐inflammatory drugs

Etsuo Mori 1, Hisao Ikeda 1,, Takafumi Ueno 1,, Hisashi Kai 1,, Nobuya Haramaki 1, Tatsuya Hashing 1, Kazuya Ichiki 1, Atsushi Katoh 1, Hiroyuki Eguchi 1, Takahisa Ueyama 1, Tsutomu Imaizumi 1
PMCID: PMC6656261  PMID: 9220183

Abstract

We report two cases of vasospastic angina associated with anaphylactic reaction caused by nonsteroidal antiinflammatory drugs (NSAIDs). Both patients exhibited anaphylactic manifestations, such as general rash and urticaria, along with angina pectoris with electrocardiographic ST‐segment elevations after suppository administration of diclofenac sodium or indomethacin, the most commonly used NSAIDs. Although these patients had normal coronary arteriograms, intracoronary administration of ergonovine or acetylcholine provoked diffuse coronary artery spasms accompanied by chest pain and ischemic ST‐segment changes. It is therefore suggested that an allergic mechanism may be involved as a causative factor of the coronary artery spasm induced by NSAIDs.

Keywords: vasospastic angina, anaphylactic reaction, diclofenac sodium, indomethacin

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