vasospastic angina

[meerkat111]

Pt is young, has drug problems, comes in obtunded after snorting cocaine and alcohol abuse. Also has redbull habit as he works many hours. Underwent CPR by his friend before arrival, Slowly regained consciousness, Echo clean, EKG only showed replo/St elev in 1 lead. X-rays clear. Was given some pain med for CPR pain.

Pt is athletic looking, 29. not common to have repolarization changes in young men.

If this is a cocaine induced vasospasm, would his echo show anything? I would think not.

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[HarryGary]

Pt is young, has drug problems, comes in obtunded after snorting cocaine and alcohol abuse. Also has redbull habit as he works many hours. Underwent CPR by his friend before arrival, Slowly regained consciousness, Echo clean, EKG only showed replo/St elev in 1 lead. X-rays clear. Was given some pain med for CPR pain.

Pt is athletic looking, 29. not common to have repolarization changes in young men.

If this is a cocaine induced vasospasm, would his echo show anything? I would think not.

If the spasm lasted long enough to cause a transmural infarct, there would certainly be a persistent wall motion abnormality. If the patient was having active chest pain, with active spasm, there would also likely be a focal wall motion abnormality that would resolve with nitroglycerin.

Google the "ischemic cascade" to understand this better.

 

[Psai]

Can get a cardiomyopathy, I think it's dilated.

 

[jdh71]

You can also get a stress induced cardiomyopathy from anything rather stressful like trying to die. I see it all the time in the ICU. But that could be a confounder per your question because the echo would be abnormal but not because of a vasospasm.