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Losartan-induced coronary artery spasm
1Department of Cardiology, University Hospital of Örebro, Örebro, Sweden. johan.josefsson@orebroll.se
BMJ Case Reports
|October 25, 2012
Summary
Losartan, a common blood pressure medication, may trigger coronary artery spasm, a serious heart condition. This case highlights the importance of considering drug-induced vasospasm in patients with acute cardiac symptoms.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- Coronary artery spasm is a transient constriction of coronary arteries, leading to myocardial ischemia.
- Losartan is an angiotensin II receptor blocker (ARB) commonly prescribed for hypertension.
- Drug-induced adverse cardiovascular events require careful clinical evaluation.
Observation:
- A patient presented with severe chest pain, ST-segment elevations, and elevated troponin I levels.
- Symptom onset occurred 15 minutes after the initial dose of losartan.
- Clinical presentation mimicked allergic reactions, but laboratory tests were inconclusive for allergy or anaphylaxis.
Findings:
- Coronary angiography confirmed the presence of coronary artery spasm.
- The temporal relationship between losartan intake and symptom onset suggests a potential causal link.
- Exclusion of allergic/anaphylactic mechanisms was supported by laboratory findings.
Implications:
- This case suggests that losartan may precipitate coronary artery spasm in susceptible individuals.
- Clinicians should consider drug-induced coronary vasospasm when evaluating patients with acute chest pain after initiating new medications.
- Further research is warranted to elucidate the mechanisms and prevalence of losartan-induced coronary artery spasm.
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