title: Coronary vasospasm during CT angiography.
abstract: A 71-year-old man, a heavy smoker, was admitted for evaluation of "chest oppression" after every dinner. Cardiac CT with a beta-blocker showed coronary stenosis in the left circumflex. Although adenosine triphosphate-stress perfusion single-photon emission CT revealed no ischemia, Holter electrocardiography belatedly indicated an ST elevation associated with his symptoms while smoking. He was diagnosed to have vasospastic angina. Cardiac CT without a beta-blocker showed thin diffuse plaque and negative remolding without any significant stenosis at the same site. Asian patients have a tendency to develop vasospastic angina. Although beta-blockers are recommended for cardiac CT, the routine administration of beta-blockers in cardiac CT may have some risk for such cases.
authors: Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan. Electronic address: takehironakahara@gmail.com.
authors: Takehiro
authors: T
authors: Nakahara
authors: Department of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.
authors: Takuji
authors: T
authors: Toyama
authors: Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors: Yoshito
authors: Y
authors: Tsushima
authors: Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors: Masahiko
authors: M
authors: Kurabayashi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D015716:Electrocardiography, Ambulatory; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D000074606:Smoking Prevention; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: Asian patients; Beta-blockers; Cardiac CT; Landiolol; Routine use; Vasospastic angina