Efficacy of Corticosteroid Treatment for Refractory Multivessel Vasospastic Coronary Angina with Hypereosinophilia

Intern Med. 2018 Nov 1;57(21):3111-3115. doi: 10.2169/internalmedicine.0886-18. Epub 2018 Jun 6.

Abstract

A 43-year-old man was diagnosed with acute myocardial infarction (AMI) due to multivessel coronary vasospasm. Accordingly, two coronary vasodilators were administered, and he was discharged without an angina attack. However, from the following day, he reported frequent chest pain and was re-hospitalized. Despite adding multiple coronary vasodilators, it was difficult to completely suppress the angina attack. He also demonstrated hypereosinophilia from the onset of AMI, and his eosinophil count gradually increased up to 6,238/μL. After corticosteroid administration was started, the vasospasm was completely controlled, and his eosinophil count normalized. He remained free from angina attacks for two years with corticosteroid therapy.

Keywords: Rho kinase inhibitor; coronary spastic angina; corticosteroid therapy; eosinophilia.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Angina Pectoris / drug therapy*
  • Coronary Vasospasm / drug therapy*
  • Humans
  • Hypereosinophilic Syndrome / drug therapy*
  • Male
  • Myocardial Infarction / diagnosis
  • Prednisolone / therapeutic use*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Prednisolone