cardiovascular-agents and Spasm

The spasm provocation tests of ergonovine and acetylcholine have been employed in the cardiac catheterization laboratory. Ergonovine acts through the serotogenic receptors, while acetylcholine acts through the muscarinic cholinergic receptors. Different mediators may have the potential to cause different coronary responses. However, there are few reports concerning the coronary response between ergonovine and acetylcholine in the same patients. Acetylcholine is supersensitive for females; spasm provoked by ergonovine is focal and proximal, whereas provoked spasm by acetylcholine is diffuse and distal. We should use both tests as supplementary in the clinic because ergonovine and acetylcholine have self-limitations to induce coronary spasms during daily life. The maximal pharmacological doses, administration methods, and the angiographical positive definition are remarkably different for each institution in the world. We recommend the pharmacological spasm provocation tests as Class I in the guidelines in patients with vasospastic angina throughout the world.

Topics: Acetylcholine; Cardiovascular Agents; Coronary Vasospasm; Ergonovine; Female; Heart; Heart Function Tests; Humans; Male; Spasm

We present the case of a 45-year-old healthy man who successfully completed three stages of the Bruce protocol but developed inferolateral ST segment elevation in the recovery phase. The ECG change was associated with a marked drop in blood pressure. He underwent emergency coronary angiography which revealed normal coronary arteries. It is likely that post-exercise hypotension triggered coronary spasm which caused the ST segment elevation. Alternatively, coronary spasm may have been the primary event, inducing sufficient myocardial ischaemia to cause a marked drop in blood pressure. Exercise tolerance testing is often a reliable test to rule out reversible myocardial ischaemia. While the physician is focused on ischaemic changes or rhythm abnormalities developing during the exercise phase, the recovery period is just as important and requires as much vigilance. Coronary vasospasm can result in significant ST changes and haemodynamic compromise at any point during the test, and the ECG traces can be indistinguishable from a classic ST elevation myocardial infarction, as in the present case.

Topics: Cardiovascular Agents; Coronary Angiography; Coronary Vessels; Diagnosis, Differential; Diltiazem; Echocardiography; Electrocardiography; Exercise Test; Humans; Male; Middle Aged; Post-Exercise Hypotension; Spasm; ST Elevation Myocardial Infarction; Treatment Outcome

In coronary artery bypass surgery, arterial grafts result in improved patency rates. However, these grafts frequently fail due to spasm. Papaverine has been used to prevent graft spasm, but its effect is short-lived. Botulinum toxin inhibits muscle contraction for about three months. We investigated the usefulness of botulinum toxin in preventing arterial grafts spasm in vitro. Samples of abdominal aorta from male Wistar rats were cut into 2 mm rings and treated with various doses of botulinum toxin or papaverine for 30 min. All rings were stimulated with KCl and noradrenaline. Tension was recorded using myography. We compared constriction caused by noradrenaline or KCl in rings treated with botulinum toxin, or papaverine, or physiological salt solution (PSS) (control). In the presence of KCl and noradrenaline, almost all concentrations of botulinum toxin completely inhibited arterial contraction when compared with controls. Spasm prevention was lost after 60 min in rings with papaverine but persisted for 120 min in rings with botulinum toxin. In the histological examination, arterial wall structure was not destroyed by botulinum toxin. Botulinum toxin prevented arterial graft spasm in vitro and had a longer lasting effect than papaverine, with no toxic effect on the artery.

Topics: Animals; Aorta, Abdominal; Aortic Diseases; Botulinum Toxins; Cardiovascular Agents; Dose-Response Relationship, Drug; In Vitro Techniques; Male; Myography; Norepinephrine; Papaverine; Potassium Chloride; Rats; Rats, Wistar; Spasm; Time Factors; Vasoconstriction; Vasoconstrictor Agents

We present three patients with variant angina pectoris and episodes of cardiac arrest. All of them had typical clinical symptoms, ST-segment changes in electrocardiogram, and coronary artery spasm confirmed by arteriography. They were treated with high doses of calcium antagonists and nitrates. An automatic cardioverter-defibrillator was implanted in the patient who developed ventricular fibrillation despite therapy with calcium antagonists. In another patient a DDD pacemaker was implanted because of high-degree atrioventricular block.

Topics: Amiodarone; Angina Pectoris, Variant; Anti-Arrhythmia Agents; Aspirin; Calcium Channel Blockers; Cardiovascular Agents; Coronary Angiography; Diltiazem; Electrocardiography; Female; Follow-Up Studies; Heart Arrest; Heart Block; Humans; Male; Middle Aged; Nitrates; Nitroglycerin; Pacemaker, Artificial; Platelet Aggregation Inhibitors; Spasm; Time Factors; Vasodilator Agents; Ventricular Fibrillation

Topics: Cardiovascular Agents; Humans; Muscle Relaxants, Central; Muscle Spasticity; Pain; Parasympatholytics; Pharmacology; Spasm

Topics: Back Pain; Cardiovascular Agents; Chlorzoxazone; Humans; Muscle Cramp; Muscle Relaxants, Central; Sciatica; Spasm

Topics: Cardiovascular Agents; Child; Chlordiazepoxide; Infant; Muscle Relaxants, Central; Muscle Spasticity; Spasm; Tranquilizing Agents

Topics: Cardiovascular Agents; Methocarbamol; Muscle Relaxants, Central; Spasm

Topics: Bile Ducts; Cardiovascular Agents; Muscle Relaxants, Central; Parasympatholytics; Spasm

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Spasm

Topics: Cardiovascular Agents; Methocarbamol; Muscle Cramp; Muscle Relaxants, Central; Nervous System Diseases; Spasm

Topics: Cardiovascular Agents; Humans; Muscle Relaxants, Central; Spasm

Topics: Animals; Cardiovascular Agents; Methocarbamol; Muscle Cramp; Muscle Relaxants, Central; Muscle, Skeletal; Spasm

Topics: Cardiovascular Agents; Chlormezanone; Muscle Relaxants, Central; Muscle Spasticity; Spasm

Topics: Cardiovascular Agents; Methocarbamol; Muscle Relaxants, Central; Orthopedics; Spasm

Topics: Cardiovascular Agents; Colon; Colonic Diseases; Disease; Muscle Relaxants, Central; Parasympatholytics; Spasm

A new skeletal muscle relaxant, methocarbamol, was used in the treatment of 38 patients with a variety of severe neurological disorders and skeletal muscle spasm states.Eighty-two per cent of the patients studied obtained a beneficial result ranging from excellent to fair. Mild side effects such as drowsiness were observed in five patients, mild weakness in three patients and excessive perspiration in one. In two of the five patients who complained of drowsiness, it disappeared upon reduction of dosage and did not reappear when original dosage was reinstituted.

Topics: Cardiovascular Agents; Disease; Humans; Methocarbamol; Muscle Relaxants, Central; Muscles; Muscular Diseases; Nervous System Diseases; Orthopedics; Spasm

Topics: Cardiovascular Agents; Humans; Muscle Relaxants, Central; Muscle, Skeletal; Muscle, Striated; Parasympatholytics; Spasm

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Phenylpropionates; Spasm

Topics: Cardiovascular Agents; Cervix Uteri; Disease; Ergot Alkaloids; Female; Humans; Obstetric Labor Complications; Pregnancy; Spasm

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Spasm

Topics: Cardiovascular Agents; Disease; Dysmenorrhea; Female; Humans; Muscle Relaxants, Central; Spasm; Urogenital System; Urologic Diseases

Topics: Cardiovascular Agents; Humans; Muscle Relaxants, Central; Spasm

Topics: Cardiovascular Agents; Central Nervous System Diseases; Muscle Relaxants, Central; Muscle Spasticity; Spasm; Syndrome

Topics: Cardiovascular Agents; Deglutition Disorders; Esophagus; Muscle Relaxants, Central; Spasm

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Muscle Spasticity; Spasm

Topics: Cardiovascular Agents; Dihydroergotamine; Ergot Alkaloids; Female; Humans; Labor, Induced; Labor, Obstetric; Oxytocics; Pregnancy; Spasm

Topics: Cardiovascular Agents; Cervix Uteri; Delivery, Obstetric; Dihydroergotamine; Ergot Alkaloids; Female; Humans; Obstetric Labor Complications; Oxytocics; Pregnancy; Spasm

Topics: Cardiovascular Agents; Humans; Muscle Relaxants, Central; Pain; Poliomyelitis; Spasm

Topics: Anesthetics; Anesthetics, Local; Cardiovascular Agents; Humans; Spasm