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At least 1,081 records · Page 60Linked to original sources
PubMed1990

A case in which coronary spasms were induced by ergonovine provocation at the sites of coronary artery ectasia.

We experienced a patient in whom coronary spasms were induced by an ergonovine provocation test during coronary angiography at the sites of coronary artery ectasia. The patient was a 45-year-old male with chest pain at rest, which promptly disappeared when given sublingual nitroglycerin. Similar attacks occurred frequently even with the administration of drugs after admission, but no significant changes were observed in electrocardiography (ECG) during the attacks or by repeated Holter ECG. The results of exercise ECG and provocation tests such as Valsalva maneuver, hyperventilation, and cold pressor test were negative. Coronary angiography showed ectatic changes in the left coronary artery, and the coronary spasms were induced by ergonovine administration at the ectatic portion of the left anterior descending artery and left circumflex artery, and right coronary artery with chest symptoms similar to those observed during spontaneous attacks. However, there were no significant changes in ECG. This rare case suggests an involvement of spasms in the pathogenic mechanism of myocardial ischemia in coronary artery ectasia.

Coronary Angiography↗
PubMed1997

Acupuncture methods for hemiplegic spasm.

Remitting hemiplegic spasticity in apoplexy (HSA) is an important problem in today's clinical study. Through teaching and clinical practice, the authors summed up the effective acupuncture methods for remitting HSA: puncture deeply the acupoints on the superior-spasm side (SSS) by filiform needles so as to obtain the intensive needling sensations in the deep tissues (ISDT) until the superior spasm is immediately remitted; tap the skin on the inferior-spasm side (ISS) by skin needles until the corresponding muscle contracts. The methods have showed a significant immediate and long-term therapeutic effect.

Acupuncture Therapy↗
PubMed1999

[Cardiac sarcoidosis complicated by multivessel coronary spasm: a case report].

A 63-year-old woman with abnormal Q waves in leads II, III, aVF developed ventricular tachycardia after an operation for thyroid carcinoma. Coronary arteriography revealed no organic stenosis, but acetylcholine induced total occlusion of the right coronary artery and severe narrowing of the left coronary artery. Left ventriculography showed inferoposterior and septal akinesis, and echocardiography revealed slight thinning of these affected walls. She had old myocardial infarction due to spasm. One year later, she developed bilateral uveitis and recurrence of tachycardia. Cardiac sarcoidosis was diagnosed by endomyocardial biopsy. In our patient with cardiac sarcoidosis, the presence of multivessel coronary spasm made the diagnosis difficult and may have contributed to cardiac dysfunction. Coronary arteries are rarely involved, but the development of coronary spasm may be linked to sarcoidosis.

Cardiomyopathies↗
PubMed2000

Catheter-induced spasm of the left main coronary artery.

Catheter-induced spasm of the left main coronary artery is rare during catheterization. We present several cases in which the occurrence of both ostial left main and right coronary spasm suggests that multiple sites of spasm may be a clue to this important diagnosis.

Cardiac Catheterization↗
PubMed1999

Spherical dilators to resolve arterial spasm.

Arterial spasms developing during microsurgical vascular anastomoses can be a difficult problem. We have been using specially developed spherical dilators in clinical practice to remove spasm that do not respond to the application of warm saline with lidocain. Dilating the spastic segment of the vessel two or three times with the instrument will usually relieve the spasm. Experimental testing of the method on the rat carotid artery has shown that using the dilator three times causes only moderate damage to the endothelium, which is largely overcome within one week. Thrombosis of the dilated artery was never seen in experimental studies and clinical use.

Anastomosis, Surgical↗
PubMed2000

[Laryngeal spasm as a symptom of ventricular volvulus].

A male patient with laryngeal spasm as the only initial symptom of gastric volvulus is described. After gastric surgery the laryngeal spasms disappeared. A possible connection between laryngeal spasm and gastroesophageal acid reflux is discussed.

Adult↗
PubMed2000

Intravenous atropine relieves coronary arterial spasm and hemodynamic decompensation during recovery after exercise.

A 66-year-old man developed right coronary arterial spasm and hemodynamic decompensation during the early recovery phase of a treadmill exercise test. The unstable condition was corrected immediately after intravenous administration of atropine. A subsequent coronary angiographic study revealed insignificant right coronary artery stenosis. The pathophysiology of this response may be related to rapid alterations in autonomic balance during recovery after exercise. To our knowledge, this is the 1st reported case in which atropine effected immediate reversal of coronary arterial spasm and hemodynamic decompensation that were induced by exercise, rather than by pharmacologic agents. Atropine might be an effective treatment in patients who experience exercise-induced coronary arterial spasm and hemodynamic decompensation, but further investigation is warranted.

Aged↗
PubMed2002

[Usefulness of multi-lead electrocardiogram and transesophageal echocardiography for the detection and evaluation of intraoperative coronary spasm].

We describe a case of coronary spasm in a 59-year-old man undergoing an emergent abdominal aortic replacement for ruptured aortic aneurysm. The patient was brought to the operating room in a state of hypovolemic shock, and was successfully resuscitated through intensive volume expansion by rapid infusion devices. Twenty minutes after cross-clamping of the abdominal aorta, ST-segment elevation on the lead III of electrocardiogram (ECG) and dyskinesis in the inferior wall shown by transesophageal echocardiography (TEE) were noted. Coronary spasm was suspected, and isosorbide dinitrate was administered intravenously without delay, leading to prompt reversal of ischemic changes. A number of reports have suggested that care should be taken against coronary spasm in non-cardiac surgery as well as cardiac surgery, especially in patients with coronary risk factors. Monitoring by multi-lead ECG and TEE is a powerful method by which to detect and evaluate intraoperative myocardial ischemia.

Aortic Aneurysm, Abdominal↗
PubMed1975

[Successful decompression of the facial nerve in facial spasm (author's transl)].

A case of successful surgical treatment of facial spasm by seventh nerve decompression is reported in a female patient who failed to improve by usual methods of treatment. Prior to surgery, tomography of the facial canal was obtained, and revealed an osseous spine involving the posterior wall of the canal. During surgery, this spine was uncovered and removed with pneumatized retrofacial air cells. The patient's spasm disappeared completely following surgery. The present case indicates that the possibility of osseous spines impinging on the facial nerve should be considered in all cases of facial spasm.

Facial Nerve↗
PubMed2002

Left ventricular pseudoaneurysm caused by coronary spasm, myocardial infarction, and myocardial rupture.

We report a very rare case of a 47-year-old man who had coronary spasm that resulted in a silent myocardial infarction, a ruptured myocardial wall, and a nonruptured left ventricular pseudoaneurysm. The patient presented with a 6-month history of dyspnea on exertion, without evidence of fixed coronary artery stenosis. Coronary angiography showed severe coronary spasm of the left anterior descending and left circumflex arteries; the spasm was relieved promptly by nitroglycerin. Echocardiography and left ventricular angiography revealed the large left ventricular pseudoaneurysm posterolateral to the left ventricle. We performed surgical resection of the pseudoaneurysm and patch repair of the ruptured left ventricular wall, with excellent results. We present this case because of the highly unusual sequence of events. Early surgical intervention resulted in the patient's recovery.

Coronary Vasospasm↗
PubMed2002

[Reversible coronary artery spasms associated with cocaine use].

A 32-year-old man developed coronary artery spasms after using cocaine. He had no significant coronary stenoses. The reversible spasms were diagnosed during heart catheterisation which was carried out because of typical chest pain and electrocardiographic changes. In young adults the use of cocaine increases the risk of a myocardial infarction by a factor of 6.9. Nevertheless, the number of people using cocaine has increased over the past years. The cardiovascular complications of using cocaine have a multifactorial pathogenesis. The treatment of coronary artery spasms may involve a calcium antagonist. Use of cocaine must be kept in mind as a cardiovascular risk factor in a patient presenting with chest pain.

Adult↗
PubMed2002

Coronary artery spasm associated with a moderately severe atherosclerotic stenosis in the proximal LAD.

Treatment of coronary artery spasm can be difficult; up to 25% of patients continue to have episodes of chest pain despite maximal therapy with calcium antagonists and nitrates. We describe the case of a 42-year-old female with severe coronary artery spasm associated with a moderately severe atherosclerotic stenosis of the proximal left anterior descending coronary artery. We discuss the diagnostic value of intravascular ultrasound and treatment options for spasm associated with atherosclerotic plaques.

Adult↗
PubMed1976

Microsurgical treatment of hermifacial spasm.

Five cases of idiopathic hemifacial spasm have been successfully treated by operative manipulation of arterial branches compressing the VIIth nerve in the posterior fossa. Terminology, clinical presentation, pathology and therapeutic approaches to hemifacial spasm are discussed. Hearing loss due to operatively induced vascular impairment of the inner ear, a complication in our first case, should be avoidable. Our experience indicates that hemifacial spasm reflects mild chronic compression of the facial nerve. The proposed mechanism is transaxonal excitation between afferent and efferent fibers.

Adult↗
PubMed2003

Diffuse coronary artery spasm induced by guidewire insertion.

Coronary artery spasm is reported to occur in 1 5% of percutaneous coronary interventions. However, coronary spasm induced solely by guidewire insertion is very rare. We present a case of diffuse coronary artery spasm induced by guidewire insertion, which responded promptly to intracoronary nitrates. The case illustrates the importance of the recognition of this phenomenon for the selection of the optimal balloon and stent size.

Aged↗
PubMed1992

[Right coronary spasm immediately after coronary artery bypass grafting for the left coronary artery].

Right coronary spasm immediately after coronary artery bypass grafting for the left coronary artery in a 39-year-old male is described. After the patient was returned to ICU, ECG at leads II, III, and aVF changed suddenly, ventricular tachycardia (right ventricle origin) and cardiac arrest ensured. As neither administration of drug nor application of D.C. was effective. The chest was reopened at ICU. Though there was sufficient flow in the left coronary artery bypass graft flow, the right ventricle did not constrict at all. Right coronary artery spasm was diagnosed, and, upon application of the direct cardiac massage and D.C. at the cardiac surface, cardiac rhythm and blood pressure were normalized. IABP was inserted to improve cardiac function, and the chest was closed. In addition, nitroglycerin and diltiazem were infused continuously. No spasm has occurred after this episode, and the patient has been discharged and is doing well.

Adult↗
PubMed1992

[A case of coronary spasm during the operation for lung cancer].

We reported a case of coronary spasm during the operation for lung cancer. A 72-year-old man underwent left upper lobectomy for lung cancer under general anesthesia with the aid of thoracic epidural anesthesia. Preoperative examinations did not reveal any clinical problems in the past. Hypotension and premature ventricular beats were observed for several times during operation due to the compression of the heart and left pulmonary artery by the surgeon's hands in stopping brisk bleeding. After this event, ST-segment of ECG was elevated abruptly. Intravenous administration of nitroglycerin was effective to relieve the coronary spasm in this case. Possible triggering factors were mechanical injury of the coronary artery due to compression of the heart, vagal stimuli under thoracic epidural anesthesia and alpha-stimulating drugs to treat hypotension. The importance of preoperative evaluation of coronary lesions, perioperative treatments with nitrates and calcium-channel blockers, and avoidance of intraoperative triggering factors are emphasized to prevent the coronary spasm.

Aged↗
PubMed1992

[Spontaneous angina caused by spasm of the left coronary artery].

A 42 year old woman presented with a one year history of retrosternal chest pain and back pain on effort and at rest sometimes accompanied by minor syncopal attacks. Transient atrioventricular block was documented during one such episode associated with hypotension. Coronary angiography showed spontaneous spasm of the left main coronary artery with clinical symptoms but no electrocardiographic changes. The spasm was relieved by injection of SIN-1. The similarity between the previous clinical symptoms and those observed at coronary angiography was in favour of the diagnosis of spasm of the left main coronary artery without atherosclerotic coronary disease. Treatment with calcium atherosclerotic coronary disease. Treatment with calcium blockers and platelet antiaggregants led to total regression of her symptoms with a follow-up of 5 months.

Adult↗
PubMed1992

[Coronary artery spasm immediately after the long-standing operation for cancer of the tongue].

A 72-year-old male underwent radical operation for cancer of the tongue. Anesthesia was maintained with the combination of enflurane-N2O-vecuronium and cervical epidural block. Five minutes after the cessation of the longstanding operation, VT and circulatory collapse occurred. After administration of lidocaine and ephedrine, VPC and ST elevation were noted, followed by VT and Vf. Cardioversion successfully restored sinus rhythm with no ST change, suggesting an episode of coronary artery spasm. The possible inducing factors in this case were hypotension and acute imbalance in autonomic nervous systems caused by hypovolemia, hypothermia, insufficient anesthetic depth, loss of surgical stress, neostigmine and epidural block. The authors reviewed case reports on coronary spasm, especially looking for possible inducing factors of coronary artery spasm during anesthesia.

Aged↗