Open AccessReversible Cerebral Vasoconstriction Syndrome Associated with Coronary Artery Vasospasm
Author(s) -
Rida Laeeq,
Jeffrey S. Berman,
Umair Khalid,
Nasser Lakkis,
Rashed Tabbaa
Publication year - 2019
Publication title -
texas heart institute journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.373
H-Index - 53
eISSN - 1526-6702
pISSN - 0730-2347
DOI - 10.14503/thij-17-6403
Subject(s) - medicine , vasoconstriction , reversible cerebral vasoconstriction syndrome , cardiology , coronary vasospasm , chest pain , diltiazem , vasospasm , cerebral vasospasm , verapamil , cerebral arteries , anesthesia , coronary artery disease , subarachnoid hemorrhage , angina , myocardial infarction , calcium
Reversible cerebral vasoconstriction syndrome is a rare disorder associated with neurologic symptoms secondary to diffuse cerebral vasospasm. Cardiac involvement in this disease is exceedingly rare. A 50-year-old woman was admitted to our hospital for evaluation of chest pain. During a 3-year period, she had been admitted multiple times because of chest pain and elevated serum cardiac enzymes. Transthoracic echocardiograms showed transient wall-motion abnormalities; however, coronary angiograms revealed no coronary artery disease. At the current admission, she had a thunderclap headache, and cerebral angiograms revealed diffuse cerebral vasoconstriction that improved after verapamil infusion, confirming the diagnosis of reversible cerebral vasoconstriction syndrome. The patient was treated successfully with oral diltiazem and had no recurrence of symptoms. We describe what we think is the first reported case of coronary artery spasm in association with reversible cerebral vasoconstriction syndrome. Future research should be focused on identifying treatment options and defining the mechanisms by which the cerebral and coronary vasculature are affected.