AI Summary & Key Takeaways
AI InsightPatient had no angina period through one year follow up treated with calcium channel blocker, nitrate and hormone replacement therapy.
📌 3 Key Takeaways
Abstract
Coronary artery spasm is a dynamic, reversible occlusion caused by the smooth muscle cell construction at the arterial wall. Postmenapausal patient admitted with a complaint of unstable angina pectoris with electrocardiographic changes and had spasm leading significant stenosis at the left main coronary artery in the performed coronary angiography. No plaque formation was seen in the intravascular ultrasound that was done because of residual stenosis after intracoronary nitroglycerin. The patient had no traditional risk factor except menapause. Endothelial protecting effects of estrogen and progesterone decrease during menapause leading to endothelial dysfunction.These suggested coronary vasospastic disease as a result of menapausal changes. Patient had no angina period through one year follow up treated with calcium channel blocker, nitrate and hormone replacement therapy.
Özet
Koroner arter spazmı arterial duvardaki düz kas hücrelerinin konstriksüyonu sonucu oluşan dinamik, reversibl oklüzyondur. Anstabil göğüs ağrısı ve elektrokardiografik değişiklikleri olan postmenopozal hastaya yapılan koroner anjiografide sol ana koroner arterde ciddi darlık yapan spazm izlendi. İntrakoroner nitrogliserin sonrası rezidü kalan hastaya intravasküler ultrasonografi (IVUS) yapıldı ve plak formasyonu izlenmedi. Menopoz dışında risk faktörü olmaması, östrojen ve progesteron hormonlarının menopozda endotelyal koruyucu etkilerinin azalması ile endotelyal disfonksiyon neden olup buna bağlı olarak koroner vazospastik hastalık gelişebileceğini düşündürdü. Kalsiyum kanal blokeri, nitrat ve hormon replasman tedavisi verilen hastanın 1 yıllık takibinde angina atağı tesbit edilmedi.