title: [Serotonin receptor blockade effective for postprandial vasospastic angina associated with dumping syndrome after esophagectomy: a case report].
abstract: A 49-year-old woman was admitted to our hospital because of frequent postprandial esophageal angina. After successful pyloric plasty, chest oppression lasting 5 to 15 min developed postprandially as well as symptoms of dumping syndrome. Electrocardiography showed ST-segment elevation in the II, III, aVf and precordial leads (V2 to V6). Finally, giant positive T waves and U waves were uniquely noted in the V1 to V5 leads. Intracoronary administration of acetylcholine (20 micrograms) provoked severe diffuse spasm in both right and left coronary arteries, chest pain and ST elevation. The conventional treatment for vasospastic angina, such as Ca2+ antagonists, nitrates and K channel opener, achieved no response. However, the combination with serotonergic receptor blockade reduced anginal attack. These findings suggest that the spastic angina in this case was partly caused by serotonin.
authors.affiliation: Integrated Medicine I, Omiya Medical Center, Jichi Medical School, Amanuma 1-847, Saitama 330-8503.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Iwasawa
authors.forename: Takanori
authors.initials: T
authors.lastname: Yasu
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Mikihisa
authors.initials: M
authors.lastname: Fujii
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kuroki
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kawakami
authors.forename: Muneyasu
authors.initials: M
authors.lastname: Saito
mesh_terms: D000787:Angina Pectoris / Q000188:drug therapy*; D003329:Coronary Vasospasm / Q000188:drug therapy*; D004377:Dumping Syndrome / Q000188:drug therapy* / Q000209:etiology; D004435:Eating; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012701:Serotonin / Q000097:blood; D012702:Serotonin Antagonists / Q000627:therapeutic use*
chemical_list: D012702:Serotonin Antagonists; D012701:Serotonin