(Circulation. 2004;109:568-572.)
© 2004 American Heart Association, Inc.
Clinician Update |
From the Coronary Artery Disease Research Unit, Cardiological Sciences, St Georges Hospital Medical School, London, UK.
Correspondence to Prof J.C. Kaski, Head, Cardiological Sciences, Director, Coronary Artery Disease Research Unit, Department of Cardiovascular Medicine, St Georges Hospital Medical School, Cranmer Terrace, London SW17 0RE, United Kingdom. E-mail jkaski@sghms.ac.uk
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
| Introduction |
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Case Report:
A 55-year-old white female pharmacist underwent diagnostic coronary arteriography for the assessment of typical exertional chest pain, which had started 18 months previously and had gradually become more frequent and severe despite treatment with oral and sublingual nitrates and atenolol (50 mg daily). Central chest pain and dyspnea occurred at rest and with emotional stress and responded rather poorly to sublingual nitrate administration. ECG exercise stress test was positive (Figure 1), and transient perfusion defects were found on thallium-201 dipyridamole testing (Figure 2). She had long-lasting excruciating chest pain after dipyridamole infusion. Risk factors included a family history of coronary artery disease, a low-density lipoprotein-cholesterol level of 4.2 mmol/L, a high-density lipoprotein-cholesterol level 0.9 mmol/L, menopausal status, a previous history of smoking, body-mass index of 28 kg/m2
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