Sea como fuere, el tratamiento prolongado con nitratos se suele acompañar de En aquellos pacientes que presentan angina de Prinzmetal sobre un fondo de . We present 2 cases of severe vasospastic angina resistant to intensive medical vagal tone associated with thyrotoxicosis triggers prinzmetal variant angina and Un tratamiento a tener en cuenta en la tirotoxicosis inducida por amiodarona. S: Coronary arterial spasm and Prinzmetal’s variant form of angina induced by hyperventilation and Tris-buffer infusion. Circulation 56, A lead ECG was obtained. From the Cattedra di Fisiopatologia Cardiorespiratoria dell.
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December Next article. Forty-eight hours later, a level of free thyroxine of 4.
CiteScore measures average citations received per document published. He underwent primary angioplasty with conventional stent implantation in mid ADA.
A repeated coronary angiography revealed a diffuse, severe spontaneous spasm of anterior descending artery ADA Figure 1which reproduced the admission clinical onset.
The journal adheres to the standards of academic research publications anginx all aspects including peer-review and ethical principles. A second catheterization ruled out complications associated with the previously implanted stentas well a development of new lesions, and the patient was discharged on calcium antagonists and nitrates.
The free thyroxine level was 6. Si continua navegando, consideramos que acepta su uso.
Thyrotoxicosis-Induced Vasospastic Angina
The main characteristic of the initial clinical course was the difficult management, with frequent anginal episodes, despite the use of high-dose calcium antagonists and nitrates.
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One year after the initiation of this medication, he was admitted to the hospital with unstable angina, with mild electrical and enzymatic changes. Iberoamerican Cardiovascular Journals Editors’ Network.
The episodes of angina at rest were uncontrollable until diagnosis and proper treatment of fisiopatoologia concomitant hyperthyroidism, the onset of which was nearly asymptomatic.
The atenolol that had originally been prescribed was discontinued. The patient was a year-old man with dilated cardiomyopathy and angiographically normal coronary arteries in 2 prior catheterizations. This time, coronary angiography revealed diffuse spasm in mid-distal ADA Figure 2which was controlled with intracoronary nitroglycerin.
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We present 2 cases of severe vasospastic angina resistant to intensive medical treatment. Print Send to a friend Export reference Mendeley Statistics.
Previous Article Vol Subscriber If you already have your login data, please click here. Three months after the procedure, he was readmitted with unstable angina after detection of transient precordial ST elevation and slight enzymatic elevation.
Thyrotoxicosis-Induced Vasospastic Angina | Revista Española de Cardiología (English Edition)
Once the diagnosis of hyperthyroidism is established, medical treatment usually suffices, although, in severe cases, most of which are induced by amiodarone, thyroidectomy may be necessary. The cardiovascular effects of hyperthyroidism are well known, and are associated with a hyperadrenergic state and an agonist effect of calcium in the myocardium. SNIP measures contextual citation impact by wighting citations based on the total number of angima in a subject field. Finally, the patient underwent total thyroidectomy, without subsequent recurrence of anginal episodes, even after the calcium antagonists were discontinued 2 months after the surgical prinzmstal.
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Angina de Prinzmetal & Sd de Takotsubo by Diego Cañar on Prezi
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The authors wish to thank the fosiopatologia for their comments and the suggested modifications, which contributed considerably to improving the manuscript. For the management of this entity, it is essential to control the thyroid activity, which can be curative in itself, obviating the need for subsequent antianginal therapy, 5 especially if there is no accompanying heart disease.
The present manuscript strengthens the hypothesis concerning causality in the association between hyperthyroidism and vasospastic angina, which, if sufficiently prolonged, can provoke myocardial infarction. Ahgina having experienced several documented episodes of atrial fibrillation and nonsustained ventricular tachycardia, the patient began to receive treatment with amiodarone, in addition to the carvedilol that he was already taking.
Thus, we highlight the importance of determining thyroid hormone concentrations in cases of vasospastic angina, especially when drug resistance is observed, 4 and peinzmetal if the signs of hyperthyroidism are mild, 2 a circumstance to which previous treatment with beta-blockers can contribute. Continuing navigation will be considered as acceptance of this use.