[Serotonin receptor blockade effective for postprandial vasospastic angina associated with dumping syndrome after esophagectomy: a case report].
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.
Iwasawa
Takamasa
T
Integrated Medicine I, Omiya Medical Center, Jichi Medical School, Amanuma 1-847, Saitama 330-8503.
Yasu
Takanori
T
Kubo
Norifumi
N
Fujii
Mikihisa
M
Kuroki
Masatoshi
M
Kawakami
Masanobu
M
Saito
Muneyasu
M
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*
D012702:Serotonin Antagonists; D012701:Serotonin