title: Metastatic carcinoid disease inducing coronary vasospasm.
abstract: Herein, we report a case of progressive coronary vasospasm in a 70-year-old man who had a long-standing history of metastatic gastrointestinal carcinoid tumor. Despite octreotide, nitrate, and calcium channel-blocker therapy, the patient's urinary 5-hydroxy-indole acetic acid level increased, coinciding with an increased frequency of flushing episodes with chest discomfort. In the cardiac catheterization laboratory, we captured an episode that was associated with diffuse right coronary artery spasm, ST-segment elevation, and intense symptoms. We attribute the patient's coronary vasospasm to his metastatic carcinoid disease.
authors.affiliation: Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 30322, USA. deapen@emory.edu
authors.forename: Danny J
authors.initials: DJ
authors.lastname: Eapen
authors.forename: Stephen
authors.initials: S
authors.lastname: Clements
authors.forename: Peter
authors.initials: P
authors.lastname: Block
authors.forename: Laurence
authors.initials: L
authors.lastname: Sperling
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D015415:Biomarkers / Q000652:urine; D002275:Carcinoid Heart Disease / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002276:Carcinoid Tumor / Q000150:complications* / Q000188:drug therapy / Q000556:secondary; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004562:Electrocardiography; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D008297:Male; D015282:Octreotide / Q000627:therapeutic use; D015607:Stents; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D014665:Vasodilator Agents; D006897:Hydroxyindoleacetic Acid; D015282:Octreotide