Microvascular Angina, on the Purpose of a Case from Southern Colombian

Santiago Emilio Campbell Silva; Carlos Hernan Calderon Franco; Diego Julian Alvis Pena; Juan David Bermeo Calderón; Luis Carlos Altahona Escobar; Díana Lizeth Grajales Trujillo; Lina Maria Gonzalez Vargas

doi:doi:10.11648/j.ijcems.20210704.12

Microvascular Angina, on the Purpose of a Case from Southern Colombian

Santiago Emilio Campbell Silva, Carlos Hernan Calderon Franco, Diego Julian Alvis Pena, Juan David Bermeo Calderón, Luis Carlos Altahona Escobar, Díana Lizeth Grajales Trujillo, Lina Maria Gonzalez Vargas

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 7, Issue 4)

Received: 1 May 2021 Accepted: 25 May 2021 Published: 9 July 2021

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Abstract

The most common cause of myocardial ischemia and angina is coronary stenosis by atheromatous lesions in the epicardial arteries. However, a significant percentage of patients with angina and ischemia demonstrated by tests to induce it not present coronary obstructions on angiography. For this reason, the case of a 68-year-old woman is presented, who consulted for chest pain with typical oppressive characteristics, associated with autonomous symptoms, with electrocardiographic changes and elevated cardiac enzymes, given the above she received anti-ischemic, antiplatelet, and analgesic, which required coronary stratification, which was later reported within normal limits. Likewise, outpatient follow-up was carried out 3 months after the cardiovascular event, reporting within normal limits. In these cases, it is attributed to coronary spasm, endothelial dysfunction, and myocardial metabolism disorders as responsible for ischemia and its clinical manifestations. This situation constitutes a frequent and costly clinical problem, contributes to diminishing the quality of life, and presents a challenge in the diagnosis and treatment. This form of angina is not as benign as it was previously considered. We present a case in which it was not possible to demonstrated ischemia by tests performed and coronary angiography revealed no obstructive lesions.

Published in	International Journal of Clinical and Experimental Medical Sciences (Volume 7, Issue 4)
DOI	10.11648/j.ijcems.20210704.12
Page(s)	81-85
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Microvascular Angina, Cardiac Syndrome X, No Obstructive Coronary Artery Disease, Chest Pain

References

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[4]	Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013; 34: 2949-3003.
[5]	Likoff W, Segal BL, Kasparian H. Paradox of normal selective coronary arteriograms in patients considered to have unmistakable coronary heart disease. N Engl J Med 1967; 276: 1063–6.
[6]	Cannon RO III, Epstein SE. ‘Microvascular angina’ as a cause of chest pain with angiographically normal coronary arteries. Am J Cardiol 1988; 61: 1338–43.
[7]	Suzuki H. Different definition of microvascular angina. Eur J Clin Invest 2015; 45: 1360–66.
[8]	Mieres JH, Shaw LJ, Arai A, et al. Role of noninvasive testing in the clinical evaluation of women with suspected coronary artery disease: consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association. Circulation 2005; 111: 682-696.
[9]	Garcia M, Miller VM, Gulati M, Hayes SN, Manson JE, Nanette K, Wenger K, et al. Focused Cardiovascular Care for Women: The Need and Role in Clinical Practice. Mayo Clin Proc. 2016; 91: 226-240.
[10]	Kobayashi Y, Fearon WF, Honda Y, Tanaka S, Pargaonkar V, Fitzgerald PJ, et al. Effect of Sex Differences on Invasive Measures of Coronary Microvascular Dysfunction in Patients With Angina in the Absence of Obstructive Coronary Artery Disease. JACC Cardiovasc Interv. 2015; 8: 1433-41.
[11]	Camici PG, D’Amati G, Rimoldi O. Coronary microvascular dysfunction: mechanisms and functional assessment. Nat. Rev. Cardiol 2015; 12: 48–62.
[12]	Herrmann J, Kaski JC, Amir Lerman A. Coronary microvascular dysfunction in the clinical setting: from mystery to reality. Eur Heart J 2012; 33: 2771–81.
[13]	Hung OY, Lee SK, Eshtehardi P, Samady H. Novel biomarkers of coronary microvascular disease. Future Cardiology 2016; 12: 497-509.
[14]	Agrawal S, Mehta PK, Bairey Merz CN. Cardiac syndrome X: update. Heart Failure Clinic 2016; 12: 141-156.
[15]	Mygind ND, Michelsen MM, Pena A, Frestad D, Dose N, Aziz A, et al. Coronary Microvascular Function and Cardiovascular Risk Factors in Women with Angina Pectoris and No Obstructive Coronary Artery Disease: The iPOWER Study. 2016; J Am Heart Assoc. 2016; 5: e003064 doi: 10.1161/JAHA.115.003064.
[16]	Sagie A, Larson MG, Goldberg RJ, Bengtson JR, Levy D. An improved method for adjusting the QT interval for heart rate (the Framingham Heart Study). Am J Cardiol 1992; 70: 797-801.

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APA Style

Santiago Emilio Campbell Silva, Carlos Hernan Calderon Franco, Diego Julian Alvis Pena, Juan David Bermeo Calderón, Luis Carlos Altahona Escobar, et al. (2021). Microvascular Angina, on the Purpose of a Case from Southern Colombian. International Journal of Clinical and Experimental Medical Sciences, 7(4), 81-85. https://doi.org/10.11648/j.ijcems.20210704.12

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ACS Style

Santiago Emilio Campbell Silva; Carlos Hernan Calderon Franco; Diego Julian Alvis Pena; Juan David Bermeo Calderón; Luis Carlos Altahona Escobar, et al. Microvascular Angina, on the Purpose of a Case from Southern Colombian. Int. J. Clin. Exp. Med. Sci. 2021, 7(4), 81-85. doi: 10.11648/j.ijcems.20210704.12

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AMA Style

Santiago Emilio Campbell Silva, Carlos Hernan Calderon Franco, Diego Julian Alvis Pena, Juan David Bermeo Calderón, Luis Carlos Altahona Escobar, et al. Microvascular Angina, on the Purpose of a Case from Southern Colombian. Int J Clin Exp Med Sci. 2021;7(4):81-85. doi: 10.11648/j.ijcems.20210704.12

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@article{10.11648/j.ijcems.20210704.12,
  author = {Santiago Emilio Campbell Silva and Carlos Hernan Calderon Franco and Diego Julian Alvis Pena and Juan David Bermeo Calderón and Luis Carlos Altahona Escobar and Díana Lizeth Grajales Trujillo and Lina Maria Gonzalez Vargas},
  title = {Microvascular Angina, on the Purpose of a Case from Southern Colombian},
  journal = {International Journal of Clinical and Experimental Medical Sciences},
  volume = {7},
  number = {4},
  pages = {81-85},
  doi = {10.11648/j.ijcems.20210704.12},
  url = {https://doi.org/10.11648/j.ijcems.20210704.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20210704.12},
  abstract = {The most common cause of myocardial ischemia and angina is coronary stenosis by atheromatous lesions in the epicardial arteries. However, a significant percentage of patients with angina and ischemia demonstrated by tests to induce it not present coronary obstructions on angiography. For this reason, the case of a 68-year-old woman is presented, who consulted for chest pain with typical oppressive characteristics, associated with autonomous symptoms, with electrocardiographic changes and elevated cardiac enzymes, given the above she received anti-ischemic, antiplatelet, and analgesic, which required coronary stratification, which was later reported within normal limits. Likewise, outpatient follow-up was carried out 3 months after the cardiovascular event, reporting within normal limits. In these cases, it is attributed to coronary spasm, endothelial dysfunction, and myocardial metabolism disorders as responsible for ischemia and its clinical manifestations. This situation constitutes a frequent and costly clinical problem, contributes to diminishing the quality of life, and presents a challenge in the diagnosis and treatment. This form of angina is not as benign as it was previously considered. We present a case in which it was not possible to demonstrated ischemia by tests performed and coronary angiography revealed no obstructive lesions.},
 year = {2021}
}

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TY  - JOUR
T1  - Microvascular Angina, on the Purpose of a Case from Southern Colombian
AU  - Santiago Emilio Campbell Silva
AU  - Carlos Hernan Calderon Franco
AU  - Diego Julian Alvis Pena
AU  - Juan David Bermeo Calderón
AU  - Luis Carlos Altahona Escobar
AU  - Díana Lizeth Grajales Trujillo
AU  - Lina Maria Gonzalez Vargas
Y1  - 2021/07/09
PY  - 2021
N1  - https://doi.org/10.11648/j.ijcems.20210704.12
DO  - 10.11648/j.ijcems.20210704.12
T2  - International Journal of Clinical and Experimental Medical Sciences
JF  - International Journal of Clinical and Experimental Medical Sciences
JO  - International Journal of Clinical and Experimental Medical Sciences
SP  - 81
EP  - 85
PB  - Science Publishing Group
SN  - 2469-8032
UR  - https://doi.org/10.11648/j.ijcems.20210704.12
AB  - The most common cause of myocardial ischemia and angina is coronary stenosis by atheromatous lesions in the epicardial arteries. However, a significant percentage of patients with angina and ischemia demonstrated by tests to induce it not present coronary obstructions on angiography. For this reason, the case of a 68-year-old woman is presented, who consulted for chest pain with typical oppressive characteristics, associated with autonomous symptoms, with electrocardiographic changes and elevated cardiac enzymes, given the above she received anti-ischemic, antiplatelet, and analgesic, which required coronary stratification, which was later reported within normal limits. Likewise, outpatient follow-up was carried out 3 months after the cardiovascular event, reporting within normal limits. In these cases, it is attributed to coronary spasm, endothelial dysfunction, and myocardial metabolism disorders as responsible for ischemia and its clinical manifestations. This situation constitutes a frequent and costly clinical problem, contributes to diminishing the quality of life, and presents a challenge in the diagnosis and treatment. This form of angina is not as benign as it was previously considered. We present a case in which it was not possible to demonstrated ischemia by tests performed and coronary angiography revealed no obstructive lesions.
VL  - 7
IS  - 4
ER  -

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Author Information

Santiago Emilio Campbell Silva

Internal Medicine Service, Medilaser Clinic, Florencia, Colombia
Carlos Hernan Calderon Franco

Internal Medicine Service, Medilaser Clinic, Florencia, Colombia
Diego Julian Alvis Pena

Hernando Moncaleano Perdomo University Hospital, Neiva, Colombia
Juan David Bermeo Calderón

Internal Medicine Service, Medilaser Clinic, Florencia, Colombia
Luis Carlos Altahona Escobar

Internal Medicine Service, Medilaser Clinic, Florencia, Colombia
Díana Lizeth Grajales Trujillo

Internal Medicine Service, Medilaser Clinic, Florencia, Colombia
Lina Maria Gonzalez Vargas

Internal Medicine Service, Medilaser Clinic, Florencia, Colombia

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APA Style

Santiago Emilio Campbell Silva, Carlos Hernan Calderon Franco, Diego Julian Alvis Pena, Juan David Bermeo Calderón, Luis Carlos Altahona Escobar, et al. (2021). Microvascular Angina, on the Purpose of a Case from Southern Colombian. International Journal of Clinical and Experimental Medical Sciences, 7(4), 81-85. https://doi.org/10.11648/j.ijcems.20210704.12

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ACS Style

Santiago Emilio Campbell Silva; Carlos Hernan Calderon Franco; Diego Julian Alvis Pena; Juan David Bermeo Calderón; Luis Carlos Altahona Escobar, et al. Microvascular Angina, on the Purpose of a Case from Southern Colombian. Int. J. Clin. Exp. Med. Sci. 2021, 7(4), 81-85. doi: 10.11648/j.ijcems.20210704.12

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AMA Style

Santiago Emilio Campbell Silva, Carlos Hernan Calderon Franco, Diego Julian Alvis Pena, Juan David Bermeo Calderón, Luis Carlos Altahona Escobar, et al. Microvascular Angina, on the Purpose of a Case from Southern Colombian. Int J Clin Exp Med Sci. 2021;7(4):81-85. doi: 10.11648/j.ijcems.20210704.12

Copy | Download

@article{10.11648/j.ijcems.20210704.12,
  author = {Santiago Emilio Campbell Silva and Carlos Hernan Calderon Franco and Diego Julian Alvis Pena and Juan David Bermeo Calderón and Luis Carlos Altahona Escobar and Díana Lizeth Grajales Trujillo and Lina Maria Gonzalez Vargas},
  title = {Microvascular Angina, on the Purpose of a Case from Southern Colombian},
  journal = {International Journal of Clinical and Experimental Medical Sciences},
  volume = {7},
  number = {4},
  pages = {81-85},
  doi = {10.11648/j.ijcems.20210704.12},
  url = {https://doi.org/10.11648/j.ijcems.20210704.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20210704.12},
  abstract = {The most common cause of myocardial ischemia and angina is coronary stenosis by atheromatous lesions in the epicardial arteries. However, a significant percentage of patients with angina and ischemia demonstrated by tests to induce it not present coronary obstructions on angiography. For this reason, the case of a 68-year-old woman is presented, who consulted for chest pain with typical oppressive characteristics, associated with autonomous symptoms, with electrocardiographic changes and elevated cardiac enzymes, given the above she received anti-ischemic, antiplatelet, and analgesic, which required coronary stratification, which was later reported within normal limits. Likewise, outpatient follow-up was carried out 3 months after the cardiovascular event, reporting within normal limits. In these cases, it is attributed to coronary spasm, endothelial dysfunction, and myocardial metabolism disorders as responsible for ischemia and its clinical manifestations. This situation constitutes a frequent and costly clinical problem, contributes to diminishing the quality of life, and presents a challenge in the diagnosis and treatment. This form of angina is not as benign as it was previously considered. We present a case in which it was not possible to demonstrated ischemia by tests performed and coronary angiography revealed no obstructive lesions.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Microvascular Angina, on the Purpose of a Case from Southern Colombian
AU  - Santiago Emilio Campbell Silva
AU  - Carlos Hernan Calderon Franco
AU  - Diego Julian Alvis Pena
AU  - Juan David Bermeo Calderón
AU  - Luis Carlos Altahona Escobar
AU  - Díana Lizeth Grajales Trujillo
AU  - Lina Maria Gonzalez Vargas
Y1  - 2021/07/09
PY  - 2021
N1  - https://doi.org/10.11648/j.ijcems.20210704.12
DO  - 10.11648/j.ijcems.20210704.12
T2  - International Journal of Clinical and Experimental Medical Sciences
JF  - International Journal of Clinical and Experimental Medical Sciences
JO  - International Journal of Clinical and Experimental Medical Sciences
SP  - 81
EP  - 85
PB  - Science Publishing Group
SN  - 2469-8032
UR  - https://doi.org/10.11648/j.ijcems.20210704.12
AB  - The most common cause of myocardial ischemia and angina is coronary stenosis by atheromatous lesions in the epicardial arteries. However, a significant percentage of patients with angina and ischemia demonstrated by tests to induce it not present coronary obstructions on angiography. For this reason, the case of a 68-year-old woman is presented, who consulted for chest pain with typical oppressive characteristics, associated with autonomous symptoms, with electrocardiographic changes and elevated cardiac enzymes, given the above she received anti-ischemic, antiplatelet, and analgesic, which required coronary stratification, which was later reported within normal limits. Likewise, outpatient follow-up was carried out 3 months after the cardiovascular event, reporting within normal limits. In these cases, it is attributed to coronary spasm, endothelial dysfunction, and myocardial metabolism disorders as responsible for ischemia and its clinical manifestations. This situation constitutes a frequent and costly clinical problem, contributes to diminishing the quality of life, and presents a challenge in the diagnosis and treatment. This form of angina is not as benign as it was previously considered. We present a case in which it was not possible to demonstrated ischemia by tests performed and coronary angiography revealed no obstructive lesions.
VL  - 7
IS  - 4
ER  -

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