title: Coronary spastic angina induced by anticholinesterase medication for myasthenia gravis--a case report.
abstract: Myasthenia gravis (MG) is characterized by weakness of skeletal muscles because of a decrease in the number of available acetylcholine receptors at neuromuscular junctions. Anticholinesterase medication is widely used to treat MG, but muscarinic side effects sometimes appear and limit the drug usage. To their knowledge, the authors present the first case of coronary spastic angina quite possibly induced by anticholinesterase medication to treat MG. The appearance of coronary spastic angina in the present case is likely mediated through the increase of acethylcholine by anticholinesterase medication.
authors.affiliation: Second Department of Internal Medicine, Ehime University School of Medicine,  Onsen-gun, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Suzuki
authors.forename: T
authors.initials: T
authors.lastname: Yoshii
authors.forename: T
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: O
authors.initials: O
authors.lastname: Sasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Hara
authors.forename: T
authors.initials: T
authors.lastname: Okura
authors.forename: Y
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: M
authors.initials: M
authors.lastname: Hamada
authors.forename: K
authors.initials: K
authors.lastname: Hiwada
mesh_terms: D000368:Aged; D000549:Ambenonium Chloride / Q000009:adverse effects* / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000175:diagnosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009157:Myasthenia Gravis / Q000188:drug therapy*
chemical_list: D002800:Cholinesterase Inhibitors; D000549:Ambenonium Chloride