Vidovich Mladen I, Ahluwalia Aneet, Manev Radmila
Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 South Wood Street, MC 715, Suite 935, Chicago, IL 60612, USA.
Cardiovasc Psychiatry Neurol. 2009;2009:453786. doi: 10.1155/2009/453786. Epub 2009 Jun 1.
Variant (Prinzmetal's) angina is an uncommon cause of precordial pain caused by coronary vasospasm and characterized by transient ST elevation and negative markers of myocardial necrosis. This is the case of a female patient with a prior history of depression and panic attacks who presented with recurrent symptoms including chest pain. A cardiac event monitor positively documented coronary vasospasm associated with anxiety-provoking chest pain, whereas the coronary arteries were angiographically normal. We noted that the frequency of angina attacks apparently increased during the period that coincided with the introduction of Bupropion SR for treatment of the patient's depression. Considering the possibility of bupropion-associated negative impact on coronary vasospasm, the antidepressant therapy was adjusted to exclude this drug. Although Prinzmetal's angina is relatively uncommon, we suspect that a routine use of cardiac event monitors in subjects with panic disorder might reveal a greater incidence of coronary vasospasm in this patient population.
变异型（普林兹金属氏）心绞痛是由冠状动脉痉挛引起的心前区疼痛的一种罕见病因，其特征为短暂性ST段抬高和心肌坏死的阴性标志物。本文报道了一名有抑郁症和惊恐发作病史的女性患者，她出现了包括胸痛在内的反复症状。心脏事件监测仪明确记录到与诱发焦虑的胸痛相关的冠状动脉痉挛，而冠状动脉造影显示正常。我们注意到，在为该患者使用安非他酮缓释片治疗抑郁症期间，心绞痛发作频率明显增加。考虑到安非他酮对冠状动脉痉挛可能产生负面影响，调整了抗抑郁治疗方案以停用该药物。虽然普林兹金属氏心绞痛相对少见，但我们怀疑在惊恐障碍患者中常规使用心脏事件监测仪可能会发现该人群中冠状动脉痉挛的发生率更高。
