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Familial catamenial coronary spasms
Elisabeth A A de Groot1, Loek van Heerebeek1, Maarten A Vink2
1Cardiology, Onze Lieve Vrouwe Hospital, Amsterdam, The Netherlands.
BMJ Case Reports
|September 25, 2024
Summary
Catamenial coronary spasms (CS), linked to menstruation, can cause myocardial infarction in young women. Early diagnosis and hormone-based treatments are crucial for managing this condition.
Area of Science:
- Cardiology
- Endocrinology
- Reproductive Medicine
Background:
- Coronary artery spasms are a significant cause of myocardial ischemia and infarction, particularly in patients with non-obstructive coronary artery disease.
- These spasms affect younger individuals and occur with similar frequency in both sexes, with potential hormonal influences beyond traditional risk factors like smoking.
Observation:
- The study presents two young sisters experiencing myocardial infarction attributed to catamenial coronary spasms (CS) during menstruation.
- In one case, CS led to severe heart failure, reduced ejection fraction, and necessitated a heart transplant due to refractory ventricular arrhythmias.
Findings:
- Catamenial coronary spasms may be triggered by hormonal fluctuations, specifically estrogen and progesterone levels, during the menstrual cycle.
- This hormonal link suggests a distinct pathophysiology for CS in susceptible individuals.
Implications:
- Increased clinical awareness of catamenial coronary spasms is vital for timely diagnosis.
- Effective management strategies may involve coronary vasodilators and/or targeted hormone replacement therapies, such as estrogen/progesterone regimens.
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