Successful Recovery after Cardiac Arrest from Medically Intractable Coronary Spasm Induced by Ergonovine, Using Percutaneous Cardiopulmonary Support -A Case Report-

다국어 초록 (Multilingual Abstract)

The ergonovine provocation test is often used in diagnosing variant angina. Most patients with an ergonovine-induced coronary artery spasm respond promptly to intracoronary nitroglycerin administration within 3 to 5 minutes. However, in a few patients ergonovine results in serious cardiovascular complications due to intractable coronary artery spasm. We report a case of a severe and medically intractable coronary spasm induced by ergonovine, followed by cardiac arrest. Aided by percutaneous cardiopulmonary support (PCPS) and mechanical ventilation, the patient could survive after four days of hospitalization despite a recurrent vasospasm. Recovery was largely attributed to full supportive care and the use of PCPS.

참고문헌 (Reference)

1 조영석, "한국인에서 산화 스트레스-관련 유전자인 Paraoxonase 및 p22phox 유전자의 다형성이 이형 협심증 및 관상동맥 협착증의 발생에 미치는 영향" 대한심장학회 33 (33): 104-112, 2003

2 김경찬, "급성심근경색증으로 발현한 이형 협심증 환자에서 5일간 지속된 가속성 심실고유 율동" 대한중환자의학회 24 (24): 33-36, 2009

3 Mishra PK, "Variations in presentation and various options in management of variant angina" 29 : 748-759, 2006

4 Kusama Y, "Variant angina and coronary artery spasm: the clinical spectrum, pathophysiology, and management" 78 : 4-12, 2011

5 Taira N, "Similarity and dissimilarity in the mode and mechanism of action between nicorandil and classical nitrates: an overview" 10 (10): S1-S9, 1987

6 Bedogni F, "Reversible cardiac arrest related to late-onset coronary spasm after a positive ergonovine test" 102 : 1905-1907, 1992

7 Bamrah VS, "Refractory coronary artery spasm" 4 : 635-639, 1984

8 Pepine CJ, "Recommendations for use of ergonovine to provoke coronary artery spasm" 6 : 423-426, 1980

9 Kurnik PB, "Prolonged coronary vasoconstrictor effect of ergonovine maleate" 10 : 353-361, 1984

10 Onaka H, "Prognostic significance of the pattern of multivessel spasm in patients with variant angina" 63 : 509-513, 1999

11 Suyama A, "Mechanisms of the ergonovine-induced vasoconstriction in the rabbit main coronary artery" 326 : 357-363, 1984

12 Myerburg RJ, "Life-threatening ventricular arrhythmias in patients with silent myocardial ischemia due to coronary-artery spasm" 326 : 1451-1455, 1992

13 Sueda S, "Frequency of provoked coronary spasms in patients undergoing coronary arteriography using a spasm provocation test via intracoronary administration of ergonovine" 55 : 403-411, 2004

14 Lee KJ, "Feasibility and safety of the transradial approach for the intracoronary spasm provocation test" 65 : 240-246, 2005

15 Hastey CE, "Ergonovine-induced coronary spasm refractory to intracoronary nitroglycerin but responsive to nitroprusside" 107 : 778-781, 1984

16 Harding MB, "Ergonovine maleate testing during cardiac catheterization: a 10-year perspective in 3,447 patients without significant coronary artery disease or Prinzmetal's variant angina" 20 : 107-111, 1992

17 Sueda S, "Coronary abnormal response has increased in Japanese patients: analysis of 17 years' spasm provocation tests in 2093 cases" 55 : 354-361, 2010

18 Takagi Y, "Clinical implications of provocation tests for coronary artery spasm: safety, arrhythmic complications, and prognostic impact: Multicentre Registry Study of the Japanese Coronary Spasm Association" 2012

19 Prinzmetal M, "Angina pectoris. I. A variant form of angina pectoris; preliminary report" 27 : 375-388, 1959

20 Pepine CJ, "Action of intracoronary nitroglycerin in refractory coronary artery spasm" 65 : 411-414, 1982