Coronary Vasospasm in a Patient With Argininosuccinic Aciduria.

Autor: Nagayoshi Y; Department of Cardiology, Amakusa Medical Center, Amakusa City, Japan; Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University, Kumamoto City, Japan. Electronic address: ynagayos@kumamoto-u.ac.jp., Nakayama M; Nakayama Cardiovascular Clinic, Amakusa City, Japan., Nagano H; Department of Cardiology, Amakusa Medical Center, Amakusa City, Japan., Morikawa K; Department of Cardiology, Amakusa Medical Center, Amakusa City, Japan., Nishi M; Department of Cardiology, Amakusa Medical Center, Amakusa City, Japan., Nishihara T; Department of Cardiology, Amakusa Medical Center, Amakusa City, Japan., Sakaino N; Department of Cardiology, Amakusa Medical Center, Amakusa City, Japan., Kawano H; Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University, Kumamoto City, Japan., Tsujita K; Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University, Kumamoto City, Japan., Mitsubuchi H; Department of Pediatrics, Graduate School of Medical Science, Kumamoto University, Kumamoto City, Japan; Division of Neonatology, Kumamoto University Hospital, Kumamoto City, Japan.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2023 Apr 01; Vol. 192, pp. 155-159. Date of Electronic Publication: 2023 Feb 18.
DOI: 10.1016/j.amjcard.2023.01.036
Abstrakt: A 39-year-old male was referred for treatment of hypertension. He had been treated for argininosuccinic aciduria since 8 months of age. Therapeutic drugs, including l-arginine, sodium phenylbutyrate, and antiepileptic drugs, had been prescribed. A detailed medical history revealed that he complained of chest discomfort under psychologic stress. A 12-lead electrocardiogram showed abnormal q waves in lead III and aVF. Transthoracic echocardiography showed hypokinesia of the left ventricular posterior wall. The patient was diagnosed with myocardial infarction because of coronary vasospastic angina by intracoronary acetylcholine provocation test. Argininosuccinic aciduria is a genetic disorder of the urea cycle caused by a deficiency of argininosuccinate lyase. Reduction of the enzymatic activity leads to a decrease in nitric oxide production, even if arginine is supplemented. Our case report supports the significance of endothelial function in the pathogenesis of coronary vasospasm.
Competing Interests: Disclosures The authors have no conflicts of interest to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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