Document Detail

Coronary vasospasm secondary to hypercholinergic crisis: an iatrogenic cause of acute myocardial infarction in myasthenia gravis.
MedLine Citation:
PMID:  16098399     Owner:  NLM     Status:  MEDLINE    
Patients with myasthenia gravis undergo lifelong treatment with anticholinesterase agents. While the heart is usually unaffected by this disease, clinicians should bear in mind the potential adverse interaction between cardiac function and the underlying myasthenic disease or its specific medications. In the present article we report, to the best of our knowledge for the first time in the literature, a case of vasospastic acute myocardial infarction due to iatrogenic hypercholinergic crisis secondary to anticholinesterase therapy in an elderly female with myasthenia gravis. This clinical vignette emphasizes the importance of taking into account the potential vasospastic effect of anticholinesterase drugs. Indeed, prompt recognition of the pathophysiology of myocardial ischemia due to iatrogenic hypercholinergic crisis is pivotal to the timely and appropriate management of this medical emergency, as well as prevention of future recurrences.
Gianluca Comerci; Antonino Buffon; Giuseppe G L Biondi-Zoccai; Vito Ramazzotti; Enrico Romagnoli; Marinica Savino; Antonio G Rebuzzi; Luigi M Biasucci; Francesco Loperfido; Filippo Crea
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Publication Detail:
Type:  Case Reports; Letter    
Journal Detail:
Title:  International journal of cardiology     Volume:  103     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-15     Completed Date:  2005-12-07     Revised Date:  2006-12-14    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  335-7     Citation Subset:  IM    
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MeSH Terms
Cholinesterase Inhibitors / adverse effects*,  therapeutic use
Coronary Angiography
Coronary Vasospasm / etiology,  physiopathology*
Myasthenia Gravis / complications,  drug therapy*
Myocardial Infarction / etiology,  physiopathology*
Pyridostigmine Bromide / adverse effects*,  therapeutic use
Reg. No./Substance:
0/Cholinesterase Inhibitors; 101-26-8/Pyridostigmine Bromide
Comment In:
Int J Cardiol. 2006 Nov 10;113(2):270-1   [PMID:  16318887 ]

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