Prinzmetal angina or coronary spasm related to anaphylactoid reaction? [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2012; 40(6): 523-526 | DOI: 10.5543/tkda.2012.23697

Prinzmetal angina or coronary spasm related to anaphylactoid reaction?

Ziad Said Dahdouh, Vincent Roule, Thérèse Lognoné, Gilles Grollier
Department of Interventional Cardiology, CHU de Caen, Caen, F-14000, France

Prinzmetal’s angina is a challenging diagnostic of spontaneous brief episodes of chest pain. Anaphylactoid reactions to radiocontrast media are immediate hypersensitivity responses that can mediate coronary artery spasm. Herein, we report the case of a 61-year-old man who underwent a coronary angiography for angina. The right coronary artery (RCA) was first visualized as normal, but during the left coronary system injections, he developed ST segment elevation and cardiogenic shock. No iatrogenic dissection of the left coronary system, which was initially normal, was displayed, but surprisingly, a retrograde supply to the RCA was visualized. Thus, we re-catheterized the RCA, which indicated a total occlusion of its second segment. Nitrate injections completely relieved the spasm and the clinical condition of the patient normalized. The possible related mechanisms are also discussed.

Keywords: Angina pectoris, coronary angiography, coronary artery disease, Prinzmetal’s angina

How to cite this article
Ziad Said Dahdouh, Vincent Roule, Thérèse Lognoné, Gilles Grollier. Prinzmetal angina or coronary spasm related to anaphylactoid reaction?. Turk Kardiyol Dern Ars. 2012; 40(6): 523-526

Corresponding Author: Ziad Said Dahdouh, France
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