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[A case of chronic hepatitis C complicated by ischemia-like changes seen on the electrocardiogram during interferon

K Yamazaki1, M Amishima, J Fujita

  • 1First Department of Medicine, Hokkaido University, School of Medicine.

Kokyu to Junkan. Respiration & Circulation
|August 1, 1993
PubMed

Insights

Interferon (IFN) alpha 2a treatment for chronic hepatitis C may trigger coronary microvessel spasms, causing chest pain and ECG changes. Symptoms resolved after discontinuing IFN, suggesting a link between the therapy and cardiac events.

Area of Science:

  • Cardiology
  • Hepatology
  • Pharmacology

Background:

  • Chronic hepatitis C is a significant global health concern.
  • Interferon (IFN) alpha 2a is a therapeutic agent used in managing chronic hepatitis C.
  • Understanding potential adverse cardiac events associated with IFN therapy is crucial for patient safety.

Observation:

  • A 53-year-old woman presented with chest pain, headache, nausea, and vomiting post-intramuscular injection of IFN alpha 2a.
  • Electrocardiogram (ECG) revealed ST depression and T inversion, indicative of myocardial ischemia.
  • Coronary angiography, cardiac enzymes, and imaging studies did not reveal obstructive coronary artery disease or myocardial infarction.

Findings:

  • The patient's symptoms and ECG abnormalities resolved upon cessation of IFN alpha 2a treatment.
  • Recurrence of similar ECG changes during provocative testing (exercise and hyperventilation) post-recovery.
  • Diagnosis of coronary microvessel spasms, potentially triggered by IFN alpha 2a, was established.

Implications:

  • IFN alpha 2a may induce coronary microvessel spasms, leading to ischemic symptoms.
  • This case highlights the importance of considering IFN-induced cardiac adverse effects in patients with hepatitis C.
  • Further research is warranted to elucidate the mechanisms and prevalence of IFN-associated coronary microvascular dysfunction.

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