Journal ArticleDOI
Refractory ergonovine-induced coronary vasospasm: Importance of intracoronary nitroglycerin
Alfred E. Buxton,Sheldon Goldberg,John W. Hirshfeld,John R. Wilson,Tift Mann,David O. Williams,Philip Overlie,Philip B. Oliva +7 more
TLDR
The ergonovine maleate test is not benign and may cause severe coronary vasospasm that is unresponsive to sublingual and intravenous nitroglycerin, but may be reversed by intracoronary nitrogoglyin.Abstract:
Recent experience has suggested that the ergonovine maleate test is a safe procedure for the diagnosis of variant angina pectoris, because ergonovine-induced coronary vasospasm has generally been reversible by sublingual nitroglycerin. This report describes five cases of ergonovine-induced coronary vasospasm that were refractory to sublingual nitroglycerin. Four of these patients had cardiac arrest. In two patients the vasospasm was responsive to intracoronary nitroglycerin administration. Three patients died as a result of the test. The two survivors differed from the nonsurvivors in the total dose of ergonovine given (0.1 and 0.15 mg versus 0.17, 0.3 and 0.3 mg, respectively) and in the method of administration of ergonovine. The survivors were given serial doses of 0.05 mg each, whereas the three nonsurvivors received either larger initial doses (0.1 followed by 0.07 mg) or progressive incremental doses (0.05, 0.1 and 0.15 mg serially). Sublingual nitroglycerin, given to all five patients, and intravenous nitroglycerin, given to three of the five, were ineffective in reversing vasospasm. Intracoronary nitroglycerin favorably altered the course of the survivors. Thus, the ergonovine maleate test is not benign and may cause severe coronary vasospasm that is unresponsive to sublingual and intravenous nitroglycerin, but may be reversed by intracoronary nitroglycerin.read more
Citations
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2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology.
Gilles Montalescot,Udo Sechtem,Stephan Achenbach,Felicita Andreotti,Chris Arden,Andrzej Budaj,Raffaele Bugiardini,Filippo Crea,Thomas Cuisset,Carlo Di Mario,J. Rafael Ferreira,Bernard J. Gersh,Anselm K. Gitt,Jean-Sébastien Hulot,Nikolaus Marx,Lionel H. Opie,Matthias Pfisterer,Eva Prescott,Frank Ruschitzka,Manel Sabaté,Roxy Senior,David P. Taggart,Ernst E. van der Wall,Christiaan J. Vrints,José Luis Zamorano,Helmut Baumgartner,Jeroen J. Bax,Héctor Bueno,Veronica Dean,Christi Deaton,Çetin Erol,Robert Fagard,Roberto Ferrari,David Hasdai,Arno W. Hoes,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Patrizio Lancellotti,Aleš Linhart,Petros Nihoyannopoulos,Massimo F Piepoli,Piotr Ponikowski,Per Anton Sirnes,Juan Tamargo,Michal Tendera,Adam Torbicki,William Wijns,Stephan Windecker,Marco Valgimigli,Marc J. Claeys,Norbert Donner-Banzhoff,Herbert Frank,Christian Funck-Brentano,Oliver Gaemperli,José Ramón González-Juanatey,Michalis Hamilos,Steen Husted,Stefan James,Kari Kervinen,Steen Dalby Kristensen,Aldo P. Maggioni,Axel R. Pries,Francesco Romeo,Lars Rydén,Maarten L. Simoons,Ph. Gabriel Steg,Adam Timmis,Aylin Yildirir +68 more
TL;DR: The If Inhibitor Ivabradine in Patients With Coronary Artery Disease and Left Ventricular Dysfunction is evaluated as well as patients with Diabetes mellitus for Optimal management of Multivessel disease.
Journal ArticleDOI
2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes.
Juhani Knuuti,William Wijns,Antti Saraste,Davide Capodanno,Emanuele Barbato,Christian Funck-Brentano,Eva Prescott,Robert F. Storey,Christi Deaton,Thomas Cuisset,Stefan Agewall,Kenneth Dickstein,Thor Edvardsen,Javier Escaned,Bernard J. Gersh,Pavel Svitil,Martine Gilard,David Hasdai,Robert Hatala,Felix Mahfoud,Josep Masip,Claudio Muneretto,Marco Valgimigli,Stephan Achenbach,Jeroen J. Bax +24 more
TL;DR: In this article, the authors present guidelines for the management of patients with coronary artery disease (CAD), which is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries.
Journal ArticleDOI
Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography.
Michel E. Bertrand,Jean-Marc Lablanche,Tilmant Py,Thieuleux Fa,M R Delforge,A G Carre,Philippe Asseman,B Berzin,C. Libersa,Laurent Jm +9 more
TL;DR: The incidence of coronary artery spasm provoked by 0.4 mg of methergine in 1089 consecutive patients undergoing coronary angiography was established and spasm occurred in 20% of patients who experienced a coronary event and in 15% of Patients who complained of chest pain.
Journal ArticleDOI
Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association
Jacqueline E. Tamis-Holland,Hani Jneid,Harmony R. Reynolds,Stefan Agewall,Emmanouil S. Brilakis,Todd M. Brown,Amir Lerman,Mary Cushman,Dharam J. Kumbhani,Cynthia Arslanian-Engoren,Ann F. Bolger,John F. Beltrame +11 more
TL;DR: This statement provides a formal and updated definition for the broadly labelled term MINOCA (incorporating the definition of acute myocardial infarction from the newly released “Fourth Universal Definition of Myocardial Infarction”) and provides a clinically useful framework and algorithms for the diagnostic evaluation and management of patients with myocardia in the absence of obstructive coronary artery disease.
Journal ArticleDOI
International standardization of diagnostic criteria for vasospastic angina
John F. Beltrame,Filippo Crea,Juan Carlos Kaski,Hisao Ogawa,Peter Ong,Udo Sechtem,Hiroaki Shimokawa,C. Noel Bairey Merz +7 more
TL;DR: The Coronary Vasomotion Disorders International Study Group (COVADIS) was established to develop international standards for the diagnostic criteria of coronary vasomotor disorders, which included the criteria for vasospastic angina.
References
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Journal ArticleDOI
Arteriographic evidence of coronary arterial spasm in acute myocardial infarction.
P B Oliva,J C Breckinridge +1 more
TL;DR: Coronary arterial spasm was demonstrated in six of fifteen acute myocardial infarctions associated with coronary artery disease and a dynamic interaction between spasm, platelet aggregates and the atherosclerotic plaque may precede coronary thrombosis.
Journal ArticleDOI
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L. D. Hillis,Eugene Braunwald +1 more
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Journal ArticleDOI
Ergonovine maleate provocative test for coronary arterial spasm.
Frederick A. Heupler,William L. Proudfit,Mehdi Razavi,Earl K. Shirey,Richard Greenstreet,William C. Sheldon +5 more
TL;DR: Coronary spasm can be implicated as a cause of myocardial infarction in patients with normal coronary arteriograms who also have Prinzmetal's variant angina and no major coronary obstructions, and ergonovine maleate test is a safe, sensitive and specific method for reproducing coronary spasm.
Journal ArticleDOI
Provocation of coronary spasm with ergonovine maleate: New test with results in 57 patients undergoing coronary arteriography☆
John S. Schroeder,James L. Bolen,Robert A. Quint,David A. Clark,William G. Hayden,Charles B. Higgins,Lewis Wexler +6 more
TL;DR: It is concluded that cautious administration of ergonovine maleate during coronary arteriography can be safely used to elicit coronary spasm in some patients who have insufficient fixed occlusive disease to explain their symptoms.
Journal ArticleDOI
Effects of ergonovine in patients with and without coronary artery disease.
TL;DR: The ergonovine test appears sensitive in confirming the presence of variant angina, and it is recommended that its use outside the cardiac catheterization laboratory is not recommended.