RESUMEN
The authors report the case of a 62-year-old woman admitted to hospital for episodes of chest pain with ischemic abnormalities at ECG without enzyme release. Coronography confirmed a normal coronary tree with mild ascending aortic dilatation. Subsequent diagnostic and clinical examinations resulted normal. Episodes of chest pain and dyspnea persisted over the following days. Administration of nitrates, calcium antagonist, diuretic, antidepressant agents for suspected syndrome X led to partial improvement of clinical symptoms. The patient was discharged from the hospital. A few days later she was referred to the neurology department because of an episode of transient dysarthria, hyposthenia and paresthesis localized to the right lower and upper limbs associated with chest pain. A brain computed tomography showed an expansive solid mass. Nuclear magnetic resonance imaging and stereotaxis biopsy confirmed the etiology of the lesion to be a glioblastoma. The patient died soon thereafter from respiratory and cardiocirculatory arrest.
Asunto(s)
Síndrome Coronario Agudo/diagnóstico , Neoplasias Encefálicas/diagnóstico , Glioblastoma/diagnóstico , Biopsia , Diagnóstico Diferencial , Electrocardiografía , Resultado Fatal , Femenino , Humanos , Espectroscopía de Resonancia Magnética , Persona de Mediana Edad , Tomografía Computarizada por Rayos XAsunto(s)
Factores Epidemiológicos , Fibrinógeno/análisis , Adolescente , Adulto , Factores de Edad , Anciano , Consumo de Bebidas Alcohólicas/sangre , Índice de Masa Corporal , Salud de la Familia , Humanos , Hiperlipidemias/sangre , Hipertensión/sangre , Italia/epidemiología , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estaciones del Año , Factores Sexuales , Fumar/sangreRESUMEN
In heart transplant recipients, the aetiology of coronary vasospasm is largely unknown but it has been reported to be related to coronary vasculopathy or allograft rejection. We report a case of acute, reversible coronary vasospasm which caused malignant arrhythmias in a cardiac transplant recipient one month after transplantation without evidence of coronary vasculopathy or allograft rejection. The patient had a normal post-operative course with no other complications; this case supports the hypothesis that coronary vasospasm is not necessarily related to epicardial coronary artery disease or allograft rejection, but rather may be due to an abnormal reversible vasoreactivity.