Arterial vasospasm

Cardiac Aortic dissection, coronary artery vasospasm, pericarditis, valvular heart disease... 

NTG causes venodilation, which lowers preload and myocardial oxygen demand. In addition, arterial vasodilation may lower BP, thereby reducing myocardial oxygen demand. Arterial dilation also relieves coronary artery vasospasm and improves myocardial blood flow and oxygenation. 

Do not give dihydroergotamine to patients with ischemic heart disease (angina pectoris, history of Ml, documented silent ischemia) or to patients who have clinical symptoms or findings consistent with coronary artery vasospasm, including Prinzmetal variant angina. 

Drug-associated cerebrovascular events and fatalities Cerebral hemorrhage, subarachnoid hemorrhage, stroke, and other cerebrovascular events have been reported in patients treated with dihydroergotamine some have resulted in fatalities. Other vasospasm-related events Dihydroergotamine, like other ergot alkaloids, may cause vasospastic reactions other than coronary artery vasospasm. Myocardial and peripheral vascular ischemia have been reported with dihydroergotamine. 

Coronary artery vasospasm Dihydroergotamine may cause coronary artery vasospasm patients who experience signs or symptoms suggestive of angina... 

Cardiac reactions (including ischemia, coronary artery vasospasm, and Ml) and noncardiac vasospasm-related reactions (such as hemorrhage and cerebrovascular accident [CVA]) occur rarely, particularly in patients with hypertension, diabetes, or a strong family history of coronary artery disease obese patients smokers. 

Folts JD, Gallagher K, Rowe GG (1982) Blood flow reductions in stenosed canine coronary arteries vasospasm or platelet aggregation Circulation 65 248-255... 

The authors concluded that intense pulmonary artery vasospasm secondary to cocaine inhalation may have caused this syndrome. 

The anthors postnlated that the combination of two sym-pathomrmetics had cansed acute coronary artery vasospasm. This is the first report linking amfebntamone to acute coronary syndrome, and one of a few cases associated with pseudoephedrine. It is also possible that erythromycin, which this patient was also taking, could have impaired the hepatic metabolism of amfebntamone. 

Abdominal distension and ileus may also be a manifestation of acute bowel infarction, a rare but catastrophic complication that results from prolonged hypotension or mesenteric artery vasospasm (caused, for ex-... 

Arterial vasospasm is the most common complication associated with passage of the guidewire and catheter into the uterine artery. Because of its diameter and tortuosity, the uterine artery is prone to spasm. In theory, embolization of an artery in spasm may not result in a lasting occlusion since relaxation of the vessel can increase luminal diameter enough to allow flow around the embolization particles [2], This may lead to a false angiographic end-point with secondary redistribution of the embolization particles [2, 10]. The systematic use of microcatheters and microguidewires has been shown to minimize the occurrence of spasm and medications such nitroglycerin or papaverine maybe effective to treat spasm [2]. 

A 31-year-old woman with no risk factors for cardiac disease had a perioperative myocardial infarction during spinal anesthesia, attributed to coronary artery vasospasm secondary to ephedrine and/or metaraminol [75 ]. 

Cardiovascular Transient branch hepatic artery vasospasm followed the intravenous administration of glucagon 1 mg on two separate occasions during visceral angiography in a 69-year-old man with a vasculitis [1 ]. 

A-17-year-old male was presented to the Emergency Department with acute onset of chest pain. Examination showed a caffeine-induced coronary artery vasospasm that was probably caused by drinking a disproportionate number of caffeinated energy drinks (three to four Redbull 80 mg of caffeine and two to three Monster 160 mg of caffeine/can [34 ]. 

Wilson RE, Kado HS, Samson R, Miller AB. A case of caffeine-induced coronary artery vasospasm of a 17-year-old male. Cardiovasc Toxicol 2012 12(2) 175-9. 

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