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Vasospastic angina pectoris associated with Churg–Strauss syndrome

Nature Clinical Practice Cardiovascular Medicine volume 2, pages 484–489 (2005)Cite this article

Abstract

Background A 50-year-old woman presented with recurrent episodes of unstable angina pectoris refractory to vasodilator treatment. Relevant coronary stenoses were excluded by coronary angiography and intravascular ultrasonography. Intracoronary infusion of acetylcholine revealed diffuse coronary vasospasms associated with clinical signs of myocardial ischemia and ST-segment elevation. Symptoms of bronchial asthma, polyneuropathy, nasal polyps, allergic rhinitis, gastritis and eosinophilia led to a diagnosis of Churg–Strauss syndrome.

Investigations Serum chemistry, coronary angiography, left-heart catheterization, intravascular ultrasonography and coronary vasospasm provocation with acetylcholine.

Diagnosis Vasospastic angina pectoris associated with Churg–Strauss syndrome.

Management Treatment with systemic corticosteroids and cyclophosphamide.

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Figure 1: Representative examples of electrocardiograms taken at rest, during an episode of vasospastic angina and after relief of symptoms with nitrates.
Figure 2: Coronary arteriogram showing epicardial vasomotor response before after infusion with intracoronary acetylcholine, and after administration of intracoronary bolus nitroglycerin.
Figure 3: Coronary arteriogram showing normal vasomotor responses taken at 3 month follow-up, after combination therapy with steroids and cyclophosphamide.

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Author notes

  1. Paraskevi Petrakopoulou, Michael Weis, Wolfgang M Franz and Peter Boekstegers: P Petrakopoulou is a Medical Doctor, M Weis an Assistant Professor of Medicine, W Franz Professor of Medicine and P Boekstegers Professor of Medicine and Vice Chair

Authors and Affiliations

  1. Department of Cardiology, University Hospital Munich, Grosshadern, Germany

    Paraskevi Petrakopoulou, Wolfgang M Franz, Peter Boekstegers & Michael Weis

Authors
  1. Paraskevi Petrakopoulou
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  2. Wolfgang M Franz
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  3. Peter Boekstegers
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  4. Michael Weis
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Correspondence to Michael Weis.

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The authors declare no competing financial interests.

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Petrakopoulou, P., Franz, W., Boekstegers, P. et al. Vasospastic angina pectoris associated with Churg–Strauss syndrome. Nat Rev Cardiol 2, 484–489 (2005). https://doi.org/10.1038/ncpcardio0299

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