Vasospastic angina pectoris associated with Churg-Strauss syndrome.

BACKGROUND

A 50-year-old woman presented with recurrent episodes of unstable angina pectoris refractory to vasodilator treatment. Relevant coronary stenoses were excluded by coronary angiography and intravascular ultrasonography. Intracoronary infusion of acetylcholine revealed diffuse coronary vasospasms associated with clinical signs of myocardial ischemia and ST-segment elevation. Symptoms of bronchial asthma, polyneuropathy, nasal polyps, allergic rhinitis, gastritis and eosinophilia led to a diagnosis of Churg-Strauss syndrome.

INVESTIGATIONS: Serum chemistry, coronary angiography, left-heart catheterization, intravascular ultrasonography and coronary vasospasm provocation with acetylcholine.

DIAGNOSIS: Vasospastic angina pectoris associated with Churg-Strauss syndrome.

MANAGEMENT: Treatment with systemic corticosteroids and cyclophosphamide.