[Vasospastic angina with angiographically normal coronary vessels of iatrogenic origin. Apropos of 2 cases].
Two cases of angina pectoris, induced by methylergometrine (Methergin) and by an association of ergotamine tartrate (Gynergene) and methysergide (Desernil) respectively, are reported. In both patients, angiography revealed spontaneous spasm in a coronary system free from any significant atheromatous stenosis. In the second case, a test administration of i.v. Methergin, administered during calcium-channel antagonist treatment a few days after the "guilty" drugs had been stopped was found to be negative. The outcome was favorable in both cases: the angina disappeared and the base-line and exercise ECG returned to normal. The hypothesis of coronary spasm induced by the treatment was adopted in both cases. In this context, the major iatrogenic etiologies of vasospastic angina are recalled, together with the prophylactic and therapeutic measures they call for.
Grand
A
A
Service de Cardiologie, Centre Hospitalier de Valence.
Fournier
E
E
Barraud
P
P
Shibli
H
H
Fichter
P
P
Lusson
J R
JR
Cassagnes
J
J
D000328:Adult; D000787:Angina Pectoris / Q000139:chemically induced*; D003329:Coronary Vasospasm / Q000139:chemically induced*; D004359:Drug Therapy, Combination; D004878:Ergotamine / Q000009:adverse effects; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008755:Methylergonovine / Q000009:adverse effects; D008784:Methysergide / Q000009:adverse effects; D008875:Middle Aged
D004878:Ergotamine; D008755:Methylergonovine; D008784:Methysergide
Angor vasopastique à coronaires angiographiquement normales d'origine iatrogène. A propos de deux nouvelles observations.