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A Case of Vasospastic Angina with Worsening of Chest Pain associated with the Administration of Nisoldipine Tomoaki Ohtsuka 1 , Mareomi Hamada 1 , Go Hiasa 1 , Osamu Sasaki 1 , Shuntaro Ikeda 1 , Hidetoshi Hashida 1 , Makoto Suzuki 1 , Yuji Hara 1 , Yuji Shigematsu 1 , Kunio Hiwada 1 1The Second Department of Internal Medicine, Ehime University School of Medicine Keyword: ニソルジピン , 冠攣縮性狭心症 , nisoldipine , vasospastic angina pp.303-306
Published Date 1999/3/15
DOI https://doi.org/10.11477/mf.1404901869
  • Abstract
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 A 50-year-old male was admitted for examination of chest pain at rest. Coronary angiography (CAG)revealed organic stenosis of neither the anterior descending artery (LAD), the left circumflex artery (LCX) nor the right coronary artery (RCA). However, significant and severe spasm was observed in RCA, LAD and LCX during an acetylcholine provocation test. Because of this, he was diagnosed as having vasospastic angina involving these three vessels. He had been treated with calcium antagonist diltiazem and isosorbide dinitrate, and his symptoms had significantly improved. However, eight months later he again complained of chest pain at rest, and 10 mg per day of nisoldipine was added to his medication. After the administration of nisoldipine, marked worsening of his chest pain was observed. He suspected that nisoldipine was responsible for the worsening of his symptoms, and he stopped using this drug. After the cessation of nisoldipine, his chest symptoms improved significantly. In this patient, we surmise that the worsening of his chest pain was associated with the administration of nisoldipine, and coronary spasms were induced by this drug. The calcium antagonists may have induced coronary vasospasm in this case, though the exact cause of coronary spasm is unknown.


Copyright © 1999, Igaku-Shoin Ltd. All rights reserved.

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