Vasospastic angina induced by nonsteroidal anti-inflammatory drugs.
We report two cases of vasospastic angina associated with anaphylactic reaction caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Both patients exhibited anaphylactic manifestations, such as general rash and urticaria, along with angina pectoris with electrocardiographic ST-segment elevations after suppository administration of diclofenac sodium or indomethacin, the most commonly used NSAIDs. Although these patients had normal coronary arteriograms, intracoronary administration of ergonovine or acetylcholine provoked diffuse coronary artery spasms accompanied by chest pain and ischemic ST-segment changes. It is therefore suggested that an allergic mechanism may be involved as a causative factor of the coronary artery spasm induced by NSAIDs.
Mori
E
E
Third Department of Internal Medicine, Kurume University School of Medicine, Japan.
Ikeda
H
H
Ueno
T
T
Kai
H
H
Haramaki
N
N
Hashino
T
T
Ichiki
K
K
Katoh
A
A
Eguchi
H
H
Ueyama
T
T
Imaizumi
T
T
D000368:Aged; D000787:Angina Pectoris / Q000139:chemically induced* / Q000175:diagnosis; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004008:Diclofenac / Q000009:adverse effects* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D007213:Indomethacin