Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Case Report: Vasospastic angina presenting as phantom odor perception.

ABSTRACT:

Background

Vasospastic angina usually presents with intermittent episodes of chest pain. It can rarely be associated with the perception of phantom odors.

Case summary

A 69-year-old woman presented for evaluation of intermittent shortness of breath and chest pain. She reported that she often experienced an abnormal smell sensation just prior to the event. The patient had abnormal smell sensation and shortness of breath at the initiation of exercise stress echocardiography with transient electrocardiographic changes and new regional wall motion abnormalities. Subsequent invasive coronary angiography showed no obstructive epicardial coronary artery disease. The patient was started on calcium channel blocker therapy with resolution of symptoms.

Conclusion

Phantom odor perception has been rarely reported as an angina-equivalent symptom. Clinicians should have a high index of suspicion in patients presenting with atypical anginal symptoms.

SUBMITTER: Zubair H

PROVIDER: S-EPMC11254699 | biostudies-literature | 2024

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Case Report: Vasospastic angina presenting as phantom odor perception.

Zubair Haroon H Suma Valentin V Masood Faisal F Jan M Fuad MF Bajwa Tanvir T Haddadian Babak B

Frontiers in cardiovascular medicine 20240704

<h4>Background</h4>Vasospastic angina usually presents with intermittent episodes of chest pain. It can rarely be associated with the perception of phantom odors.<h4>Case summary</h4>A 69-year-old woman presented for evaluation of intermittent shortness of breath and chest pain. She reported that she often experienced an abnormal smell sensation just prior to the event. The patient had abnormal smell sensation and shortness of breath at the initiation of exercise stress echocardiography with tra ...[more]

PMID: 39027001

Similar Datasets

Exercise-induced vasospastic angina with prominent ST elevation: a case report.

Project description:BackgroundExercise-induced vasospastic angina (VSA) is a relatively uncommon clinical scenario but may be fatal if not appropriately managed.Case summaryA 56-year-old male patient presented to our hospital for chest oppression on exertion for a 2-week duration. The symptom arose while he was riding a bicycle in the morning but did not arise at rest or on exertion in the afternoon. He was an ex-smoker with a history of hypertension and a family history of sudden death. A resting electrocardiogram (ECG) was normal, and echocardiogram revealed no wall motion abnormalities. Coronary computed tomography angiography indicated a possible stenotic lesion in the circumflex branch. Thus, hospitalization was arranged, and transcatheter coronary angiography (CAG) was performed. In CAG, there was only mild stenosis with small perfusion area in the obtuse marginal branch. A treadmill exercise test was performed the following day to assess the contribution of cardiac ischaemia to his chest symptom on exertion. At 10 metabolic equivalents, he suddenly developed chest pain and prominent ST elevation in leads II, III, aVF, and V2-5 was noted on ECG. The test was immediately terminated, and nitrates were administered. The symptom disappeared, and the patient's ECG normalized, confirming the diagnosis of exercise-induced VSA. Another treadmill exercise test was performed 6 days after vasodilators were started. Even at maximum exercise intensity, neither chest symptoms nor ischaemic changes occurred. The patient was discharged, and the chest symptoms have not returned.DiscussionThis case highlights the importance of appropriate diagnosis and management of exercise-induced VSA.

| S-EPMC6426112 | biostudies-literature

Refractory vasospastic angina in a patient with fibromuscular dysplasia: A case report.

Project description:A 49-year-old woman affected by fibromuscular dysplasia (FMD) of the carotid artery with recurrent coronary vasospasm, refractory to medical therapy was admitted for anginal pain. Coronary involvement related to FMD is uncommon and its diagnosis "in vivo" still represents a challenge. Although a clear association between FMD and spontaneous coronary artery dissections is described, the presentation as severe coronary vasospasm is rare and it is associated with unfavorable outcome, especially when treated by means of percutaneous coronary intervention. The use of intravascular ultrasound played a key role in choosing the appropriate strategy for the management of the patient. <Learning objective: During the past years fibromuscular dysplasia (FMD) has been recognized as an underdiagnosed underlying pathology possibly associated with acute coronary syndromes, especially in the setting of young women. Coronary involvement has been recently associated with vasospasm, reported in previous cases as severe refractory vasospasm. Intravascular imaging techniques are able to detect FMD structural coronary abnormalities, aiming for clinicians to choose the appropriate strategy for the management of the patient.>.

| S-EPMC8165668 | biostudies-literature

Ventricular fibrillation associated with vasospastic angina pectoris in Fabry disease: a case report.

Project description:BackgroundFabry disease (FD) is an X-linked lysosomal storage disorder resulting from a deficiency in alpha-galactosidase A. The major causes of death due to cardiac complications include life-threatening arrhythmias. In addition, life-threatening arrhythmias may be related to myocardial fibrosis assessed by late gadolinium enhancement (LGE).Case summaryA 43-year-old man with sinus bradycardia and left ventricular hypertrophy was referred to our cardiology department. Family history includes unexplained hypertrophy and sick sinus syndrome in mother. Additionally, his plasma alpha-galactosidase A activity was low. He was subsequently diagnosed with FD. Enzyme replacement therapy using 1.0 mg/kg agalsidase-β was initiated. During the fifth administration, he developed ventricular fibrillation (VF). Electrocardiography conducted immediately before VF revealed ST elevation in the inferior leads with reciprocated ST depression. Cardiac magnetic resonance imaging showed no LGE in the myocardium. Coronary angiography showed no organic stenosis; moreover, coronary spasms were induced by an intracoronary acetylcholine injection. Ventricular fibrillation was not observed as the patient received calcium antagonists.DiscussionThis report suggests that vasospastic angina pectoris is associated with life-threatening arrhythmias in patient with FD without LGE.

| S-EPMC7042139 | biostudies-literature

Healed plaque erosion as a cause of recurrent vasospastic angina: a case report.

Project description:BackgroundRecurrent vasospastic angina sometimes occurs. Fresh thrombi have been known to arise without plaque rupture at coronary spasm sites due to blood flow stagnation and intimal erosion caused by vasospasms. The relationship between recurrence of vasospastic angina and thrombus formation remains unclear.Case summaryA 67-year-old man presented with sudden chest pain at rest. Electrocardiography and coronary angiography indicated vasospastic angina. His chest pain persisted despite the administration of benidipine, isosorbide mononitrate, nicorandil, and nifedipine. Coronary angiography performed one month after initial presentation showed stenosis refractory to isosorbide administration. Optical coherence tomography revealed a healed plaque, and a stent was deployed. The patient remained symptom-free at 1-year follow-up.DiscussionProlonged coronary vasospasm with limited coronary blood flow could induce total occlusion of the coronary artery, and acute thrombus formation, which resulted in healed plaque erosion. When vasospastic angina cannot be controlled, rapidly progressive stenosis caused by healed plaque erosion could be its underlying cause and mechanism. This report indicates that antiplatelet therapy may be a preventive option for future recurrent vasospastic angina, especially in those caused by healed plaques.

| S-EPMC8564684 | biostudies-literature

Successful treatment of vasospastic angina refractory to various therapies using stenting: A case report.

Project description:We encountered a case of coronary angina refractory to multiple medications, including a calcium channel blocker, nitroglycerin, fasudil (a Rho kinase inhibitor), left stellate ganglion block, thoracic sympathetic ganglion blockade, steroids, and denopamine. During the course of treatment, ventricular tachycardia (VT) occurred due to ST-segment elevation, and an implantable cardioverter-defibrillator was implanted; however, the patient had recurrent VT. A 12‑lead electrocardiogram showed ST elevation localized to leads II, III, and a Vf, and stenting was performed in all main trunks of the right coronary artery. After stenting, the daily angina attacks stopped, VT disappeared, and the chronic phase was controlled with her existing drug therapy, although she had mild chest pain attacks. There is limited evidence regarding the treatment of refractory angina pectoris. In this case, a patient with coronary angina pectoris refractory to various therapies underwent stenting, and the potentially fatal arrhythmia disappeared.Learning objectiveManagement of refractory coronary angina pectoris poses a challenge. Despite attempting conventional therapies, our initial efforts were met with unsuccessful outcomes. Finally, we succeeded in treating the patient with stenting. This case report underscores the challenge of managing refractory coronary angina and explores diverse therapeutic approaches, including conventional medications, sympathetic nerve interventions, and stent placement.

| S-EPMC11523208 | biostudies-literature

A case of vasospastic angina with exertional sign.

Project description:We herein report a case of a 56-year-old woman with angina pectoris. She visited our emergency room because of chest pain. She finally underwent emergency percutaneous coronary intervention in right coronary artery due to acute coronary syndrome. Several months later, she complained of exertional chest pain again. Exercise-stress electrocardiogram showed ST-segment depression in V2-V6. However, coronary angiography showed no organic stenosis and we conducted acetylcholine provocation test. We finally detected severe coronary artery spasm and diagnosed exercise-induced vasospastic angina (VSA). This case highlights the importance of the recognition of exercise-induced VSA. Exercise-induced VSA needs the definite diagnosis and appropriate treatment. Learning objective Many patients felt chest pain even if they have undergone percutaneous coronary intervention (PCI). This case highlights the importance of the recognition of exercise-induced vasospastic angina (VSA). Exercise-induced VSA needs definite diagnosis and appropriate treatment. This case report describes the importance of precise diagnosis and highlights the recognition of exercise-induced VSA. We recommend the acetylcholine provocation test after PCI in order to determine the diagnosis of exercise-induced VSA.

| S-EPMC8758595 | biostudies-literature

Treatment of refractory vasospastic angina complicated by acute pulmonary oedema with levosimendan: a case report.

Project description:BackgroundVasospastic angina (VA) is an important cause of chest pain and patients often have 3- to 6-month clusters of recurrent attacks, separated by relatively asymptomatic periods. During these episodes the resulting myocardial ischaemia can lead to clinical complications of different severity, including acute myocardial infarction, acute heart failure, and cardiogenic shock. The management of severe and recurrent VA attacks is challenging, and no specific recommendations exist in recent cardiologic guidelines on the pharmacological strategy (inotropic/vasopressor agents) to adopt for this acute clinical setting.Case summaryWe present a case of recurrent episodes of VA complicated by acute pulmonary oedema and cardiogenic shock despite maximal tolerated therapy (intravenous calcium antagonist and nitrates) that was successfully treated with levosimendan.DiscussionLevosimendan rapidly reverted cardiogenic shock, acute pulmonary oedema, and mitral regurgitation caused by a refractory coronary spasm, contributing to persistent clinical stabilization. Further evidence and a longer follow-up are needed to support our observation on the efficacy of levosimendan in this specific clinical setting.

| S-EPMC6439361 | biostudies-literature

Exercise-induced vasospastic angina diagnosed with a hand grip test in the catheterization laboratory: a case report.

Project description:BackgroundExercise-induced vasospastic angina (VSA) is a relatively uncommon clinical scenario and is difficult to diagnose in the catheterization laboratory.Case summaryA 61-year-old Japanese man presented to our hospital with complaints of angina upon exertion in the morning. Neither a 12-lead electrocardiogram nor an echocardiogram showed any abnormal findings. Invasive coronary angiogram revealed moderate stenosis in the left anterior descending coronary artery. A hand grip test was performed, during which the patient experienced chest pain, and coronary angiogram showed coronary spasm at the site of organic stenosis with delayed coronary flow. Intracoronary nitrates (300 ug) were administered, resulting in the release of coronary spasm.ConclusionThe hand grip test may serve as a useful method for diagnosing exercise-induced VSA in the catheterization laboratory.

| S-EPMC10768985 | biostudies-literature

Immunotherapy-mediated myocarditis and concurrent vasospastic angina in a patient with established ischaemic heart disease: a case report.

Project description:BackgroundImmunotherapy has become a pillar of modern oncological management but is associated with significant immunotherapy-related adverse events (IRAEs). While myocarditis is a prominent IRAE which clinicians are increasingly aware of, immunotherapy-related coronary vasospasm is far less appreciated and can be especially difficult to elucidate in pre-existing coronary artery disease. This case demonstrates the approach to diagnosis and management of multiple cardiovascular and non-cardiovascular IRAEs.Case summaryA 57-year-old male with a history of metastatic melanoma on combined immunotherapy and ischaemic heart disease with multiple previous percutaneous coronary interventions presented with typical chest pain and troponin rise. Differential diagnoses for this presentation included a non-ST elevation myocardial infarction, myocarditis, and coronary vasospasm. Coronary angiogram did not reveal any new significant obstructive coronary artery disease while cardiac MRI did not reveal any radiological features consistent with myocarditis. However, empirical treatment for IRAEs resulted in both clinical and biochemical improvement and ability to discharge the patient on steroids and coronary vasodilators, having been GTN-infusion dependent as an inpatient.DiscussionCardiovascular IRAEs are important to be aware of when managing patients on immunotherapy and more than one IRAE can occur concurrently. Given the caveats of non-invasive imaging and invasive nature of endomyocardial biopsy, the clinical history is key in establishing these crucial diagnoses which will significantly impact ongoing oncological management.

| S-EPMC11630064 | biostudies-literature

Relation Between Cancer and Vasospastic Angina.

Project description:IntroductionPatients with cancer have an increased risk of cardiovascular disease including ischemic heart disease and vice versa. Anticancer drugs and radiotherapy are known to contribute to endothelial injury and vasospasm. However, the relations between vasospastic angina (VSA) and cancer or its treatment are poorly investigated.MethodsA total of 786 patients underwent intracoronary acetylcholine (ACh) provocation tests to diagnose VSA. The positive ACh provocation test was defined as angiographic coronary artery spasm accompanied by chest pain and/or ischemic electrocardiographic changes. Patients were divided into active cancer, a history of cancer, and no cancer according to the status of malignancy. The impact of types of cancer, anticancer drugs, and radiotherapy on VSA was evaluated.ResultsOf 786 patients, 38 (4.8%) and 84 (10.7%) had active cancer and a history of cancer, respectively, and 401 (51.0%) were diagnosed as VSA. There was no significant difference in rates of positive ACh test among patients with active cancer, a history of cancer, and no cancer (39.5% vs. 57.1% vs. 50.9%, p = 0.20). Types of cancer and cancer treatment also had no impact on positive ACh provocation test.ConclusionsIn this cross-sectional observational study, we did not find an association of active and a history of cancer with the diagnosis of VSA. Anticancer treatment including chemotherapy and radiotherapy was not significantly associated with positive ACh provocation test.

| S-EPMC8342335 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data