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Case Reports
. 2022 Jun 8;14(6):e25748.
doi: 10.7759/cureus.25748. eCollection 2022 Jun.

Tacrolimus-Induced Diffuse Coronary Artery Spasm

Abadil Samer  1 , Fahad Almehmadi  1 , Ahmed Krimly  2 , Abdullah Alrajhi  3
Affiliations
Case Reports

Tacrolimus-Induced Diffuse Coronary Artery Spasm

Abadil Samer et al. Cureus. .

Abstract

Prinzmetal angina, also known as vasospastic angina, is defined as an intermittent focal or diffuse coronary artery narrowing, which is often associated with transient ST-segment elevation on an electrocardiogram. Also, it could be associated with an atherosclerotic lesion at the site of the spasm. Vasospastic angina might be induced by medications, most commonly with cocaine and other examples which include catecholamines such as epinephrine, norepinephrine, isoproterenol, dopamine, and dobutamine. Parasympathomimetic agents include acetylcholine, methacholine, and pilocarpine. It is rarely caused by tacrolimus. The clinical evaluation includes an electrocardiogram and echocardiogram. The confirmed diagnosis is done by coronary angiography. Cardiac catheterization is indicated in such cases to rule out coronary artery disease.

Keywords: coronary artery spasm; immunosuppressant; renal failure; solid organ transplant; tacrolimus.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Electrocardiogram (ECG) showing ST-elevation in V2-6 and aVL
Figure 2
Figure 2. Severe left anterior descending (LAD) artery spasm
Figure 3
Figure 3. Coronary angiogram two days later showed complete resolution of the coronary spasm
See this image and copyright information in PMC

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