Acute Myocardial Ischemia Secondary to Coronary Vasospasm From Long-Term High-Dose Caffeine Consumption

Area of Science:

• Cardiology
• Emergency Medicine
• Pharmacology

Background:

• Chest pain is a common emergency department complaint, with ST-elevation myocardial infarction (STEMI) being a critical diagnosis.
• Variant angina, characterized by reversible coronary vasospasm, is a rare mimic of STEMI, often associated with nonobstructive coronary artery disease.
• The exact mechanisms precipitating vasospastic events are not fully understood, though arterial wall dysfunction and vasoactive substances are implicated.

Purpose of the Study:

• To report a unique case of variant angina.
• To investigate the potential association between chronic high caffeine consumption and the development of coronary vasospasm.
• To differentiate this case from previously reported instances of vasospasm linked to acute caffeine overdose.

Main Methods:

• Case report detailing a 30-year-old male firefighter presenting with symptoms suggestive of cardiac events.
• Detailed patient history including daily caffeine consumption (approximately 900 mg).
• Diagnostic workup to confirm variant angina and rule out other causes of chest pain.

Main Results:

• The patient, a physically fit male with high daily caffeine intake, was diagnosed with confirmed variant angina.
• This case represents the first documented instance of vasospasm associated with chronic high caffeine consumption, rather than a single overdose.
• The findings suggest a potential link between habitual excessive caffeine intake and coronary vasospasm.

Conclusions:

• Chronic high caffeine consumption may be a contributing factor to variant angina.
• This case broadens the understanding of triggers for coronary vasospasm.
• Further research is warranted to explore the relationship between caffeine and vasospastic angina.