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Updated: Jul 2, 2026
06:18
Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm
Published on: September 17, 2021
Eosinophilia and coronary artery vasospasm
Chi Wing Wong1, Sushil Luis, Irene Zeng
1Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
Heart, Lung & Circulation
|August 23, 2008
Summary
Coronary vasospasm linked to eosinophilia often leads to recurrent heart events and responds poorly to typical treatments. Prednisone, which suppresses eosinophilia, significantly reduces these events.
Area of Science:
- Cardiology
- Hematology
- Immunology
Background:
- Eosinophilia, a condition characterized by elevated eosinophil counts, can be associated with various systemic diseases.
- Coronary artery vasospasm is a condition involving spasms of the coronary arteries, leading to reduced blood flow to the heart muscle.
Observation:
- This study describes two patients with eosinophilia experiencing recurrent acute coronary events due to multi-vessel coronary artery spasm.
- A systematic literature review identified 17 additional cases, totaling 19 patients with eosinophilia and coronary artery vasospasm.
Findings:
- Patients presented with angina at rest and elevated cardiac markers, often showing dynamic ST elevation.
- Coronary angiography revealed multi-focal coronary artery spasm in 83% of patients.
- Symptoms persisted with high-dose vasodilators but improved with prednisone, which suppressed eosinophilia. Recurrent events were significantly lower on prednisone (0.4 events/year) compared to off-prednisone (4.2 events/year).
Implications:
- Coronary vasospasm associated with eosinophilia has a poor prognosis with conventional vasodilator therapy.
- Treatment targeting eosinophilia, such as with prednisone, appears effective in reducing recurrent coronary events.
- Further research is warranted to elucidate the mechanisms and optimize management strategies for this rare condition.
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