title: Intractable Coronary Spastic Angina Improvement after Continuous Combined Estrogen-progestin Hormonal Contraception Use in a Premenopausal Woman.
abstract: A 44-year-old woman, who had been previously diagnosed with coronary spastic angina and treated with standard medical therapy including calcium channel blockers, was admitted to our hospital due to chest pain at rest. Her chest pain attacks were concentrated just before and during menstruation. Despite the administration of an intravenous infusion of nitroglycerin and nicorandil, strong heart attacks with ST elevation occurred frequently after this admission. However, following continuous combined estrogen-progestin hormonal contraception use (estradiol plus dienogest), her attacks disappeared completely. Reduced estrogen levels before and during menstruation were speculated to be associated with her angina attacks.
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Adachi
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ikeda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakakura
authors.forename: Sachiho
authors.initials: S
authors.lastname: Netsu
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ibe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Momomura
authors.forename: Hideo
authors.initials: H
authors.lastname: Fujita
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002637:Chest Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D003329:Coronary Vasospasm / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D020108:Nicorandil / Q000627:therapeutic use; D005996:Nitroglycerin / Q000008:administration & dosage; D011372:Progestins / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D003277:Contraceptives, Oral, Combined; D004967:Estrogens; D011372:Progestins; D020108:Nicorandil; D005996:Nitroglycerin