Document Detail

Nitrate tolerance as a possible cause of multidrug-resistant coronary artery spasm.
MedLine Citation:
PMID:  20558913     Owner:  NLM     Status:  MEDLINE    
Coronary spasm can usually be controlled by administration of Ca antagonists. However, there are some cases of coronary spasm whose attacks cannot be controlled even with large doses of Ca antagonist and/or its combination with nitrates. Here we describe the case of a 41-year-old man whose attacks of coronary spasm were resistant to the combined administration of nitrates, Ca antagonists, and a statin. The attacks were alleviated and disappeared after withdrawal of nitrates and recurred after readministration of a nitroglycerin patch. The involvement of nitrate tolerance in the pathogenesis of multidrug resistant coronary spasm was revealed and its implication discussed.
Yoshinobu Morikawa; Yuji Mizuno; Eisaku Harada; Osamu Kuboyama; Michihiro Yoshimura; Hirofumi Yasue
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International heart journal     Volume:  51     ISSN:  1349-2365     ISO Abbreviation:  Int Heart J     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  211-3     Citation Subset:  IM    
Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan.
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MeSH Terms
Calcium Channel Blockers / adverse effects
Coronary Vasospasm / chemically induced*,  diagnosis*,  therapy
Drug Resistance, Multiple
Drug Tolerance / physiology*
Nitrates / adverse effects*
Nitroglycerin / adverse effects
Vasodilator Agents / adverse effects
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Nitrates; 0/Vasodilator Agents; 55-63-0/Nitroglycerin

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