Introduction: Prinzmetal angina is a special type of acute coronary syndrome ST+ wich correspond to a transient occlusion of a coronary vessel secondary to spasm. This type of acute coronary syndrome is very rare and is characterized by the presence of signs of myocardial ischemia on electrocardiogram but coronary angiography and coroscaner are frequently normals. Its management in hemophilia patients is difficult because of the use of anticoagulant and antiplatelet drugs wich increase bleeding risk. We report the case of a major hemophilia A patient which presented Prinzmetal angina. Observation : It is a 64 years old patient, hemophilia A major, chronic smoking (40 pack-year), not diabetic, not hypertensive, which had a retro sternal constrictive pain radiating to the shoulders. At admission he was consciousness. No breath in cardiac auscultation. The electrocardiography showed a heart rate at 61bpm, the axis of the heart was normal. ST-segment elevation was noticed in DIII and AVF : ischemia in the cardiac lower area. Echocardiography was normal. The coroscaner was normal. The troponin I level was at 0.03 µg / L (Normal : 0-0.1µg/L). This patient had a variant Prinzmetal angina. Treatement: Diltiazem Hydrochloride 60 mg 1 tablet / 8 hours. Acetylsalicylic acid 160 mg IV and Clopidogrel 300 mg IV the first day ; relay with acetylsalicylic acid 100 mg and clopidogrel 75 mg per day. Transfusion of factor VIII at the dose of 40UI / Kg. Simvastatin 20 mg 1 tablet per day. Perindopril 5 mg 1 tablet the day. The evolution was favorable. Discussion and conclusion: Coronary syndromes are not frequent in morocco hemophilia patients. Their management is complex and involves the presence of an hematologist.
| Published in | American Journal of Internal Medicine (Volume 3, Issue 4) |
| DOI | 10.11648/j.ajim.20150304.17 |
| Page(s) | 194-196 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2015. Published by Science Publishing Group |
Acute Coronary Syndrome, Hemophilia, Management
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APA Style
Romaric Mahutondji Massi, Bienvenu Houssou, Marième Camara, Nisrine Khoubila, Asma Quessar, et al. (2015). Prinzmetal Angina in Major Hemophilia a Patient: A Case Report. American Journal of Internal Medicine, 3(4), 194-196. https://doi.org/10.11648/j.ajim.20150304.17
ACS Style
Romaric Mahutondji Massi; Bienvenu Houssou; Marième Camara; Nisrine Khoubila; Asma Quessar, et al. Prinzmetal Angina in Major Hemophilia a Patient: A Case Report. Am. J. Intern. Med. 2015, 3(4), 194-196. doi: 10.11648/j.ajim.20150304.17
AMA Style
Romaric Mahutondji Massi, Bienvenu Houssou, Marième Camara, Nisrine Khoubila, Asma Quessar, et al. Prinzmetal Angina in Major Hemophilia a Patient: A Case Report. Am J Intern Med. 2015;3(4):194-196. doi: 10.11648/j.ajim.20150304.17
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Download@article{10.11648/j.ajim.20150304.17,
author = {Romaric Mahutondji Massi and Bienvenu Houssou and Marième Camara and Nisrine Khoubila and Asma Quessar and Bouchra Oukkache},
title = {Prinzmetal Angina in Major Hemophilia a Patient: A Case Report},
journal = {American Journal of Internal Medicine},
volume = {3},
number = {4},
pages = {194-196},
doi = {10.11648/j.ajim.20150304.17},
url = {https://doi.org/10.11648/j.ajim.20150304.17},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20150304.17},
abstract = {Introduction: Prinzmetal angina is a special type of acute coronary syndrome ST+ wich correspond to a transient occlusion of a coronary vessel secondary to spasm. This type of acute coronary syndrome is very rare and is characterized by the presence of signs of myocardial ischemia on electrocardiogram but coronary angiography and coroscaner are frequently normals. Its management in hemophilia patients is difficult because of the use of anticoagulant and antiplatelet drugs wich increase bleeding risk. We report the case of a major hemophilia A patient which presented Prinzmetal angina. Observation : It is a 64 years old patient, hemophilia A major, chronic smoking (40 pack-year), not diabetic, not hypertensive, which had a retro sternal constrictive pain radiating to the shoulders. At admission he was consciousness. No breath in cardiac auscultation. The electrocardiography showed a heart rate at 61bpm, the axis of the heart was normal. ST-segment elevation was noticed in DIII and AVF : ischemia in the cardiac lower area. Echocardiography was normal. The coroscaner was normal. The troponin I level was at 0.03 µg / L (Normal : 0-0.1µg/L). This patient had a variant Prinzmetal angina. Treatement: Diltiazem Hydrochloride 60 mg 1 tablet / 8 hours. Acetylsalicylic acid 160 mg IV and Clopidogrel 300 mg IV the first day ; relay with acetylsalicylic acid 100 mg and clopidogrel 75 mg per day. Transfusion of factor VIII at the dose of 40UI / Kg. Simvastatin 20 mg 1 tablet per day. Perindopril 5 mg 1 tablet the day. The evolution was favorable. Discussion and conclusion: Coronary syndromes are not frequent in morocco hemophilia patients. Their management is complex and involves the presence of an hematologist.},
year = {2015}
}
TY - JOUR T1 - Prinzmetal Angina in Major Hemophilia a Patient: A Case Report AU - Romaric Mahutondji Massi AU - Bienvenu Houssou AU - Marième Camara AU - Nisrine Khoubila AU - Asma Quessar AU - Bouchra Oukkache Y1 - 2015/07/31 PY - 2015 N1 - https://doi.org/10.11648/j.ajim.20150304.17 DO - 10.11648/j.ajim.20150304.17 T2 - American Journal of Internal Medicine JF - American Journal of Internal Medicine JO - American Journal of Internal Medicine SP - 194 EP - 196 PB - Science Publishing Group SN - 2330-4324 UR - https://doi.org/10.11648/j.ajim.20150304.17 AB - Introduction: Prinzmetal angina is a special type of acute coronary syndrome ST+ wich correspond to a transient occlusion of a coronary vessel secondary to spasm. This type of acute coronary syndrome is very rare and is characterized by the presence of signs of myocardial ischemia on electrocardiogram but coronary angiography and coroscaner are frequently normals. Its management in hemophilia patients is difficult because of the use of anticoagulant and antiplatelet drugs wich increase bleeding risk. We report the case of a major hemophilia A patient which presented Prinzmetal angina. Observation : It is a 64 years old patient, hemophilia A major, chronic smoking (40 pack-year), not diabetic, not hypertensive, which had a retro sternal constrictive pain radiating to the shoulders. At admission he was consciousness. No breath in cardiac auscultation. The electrocardiography showed a heart rate at 61bpm, the axis of the heart was normal. ST-segment elevation was noticed in DIII and AVF : ischemia in the cardiac lower area. Echocardiography was normal. The coroscaner was normal. The troponin I level was at 0.03 µg / L (Normal : 0-0.1µg/L). This patient had a variant Prinzmetal angina. Treatement: Diltiazem Hydrochloride 60 mg 1 tablet / 8 hours. Acetylsalicylic acid 160 mg IV and Clopidogrel 300 mg IV the first day ; relay with acetylsalicylic acid 100 mg and clopidogrel 75 mg per day. Transfusion of factor VIII at the dose of 40UI / Kg. Simvastatin 20 mg 1 tablet per day. Perindopril 5 mg 1 tablet the day. The evolution was favorable. Discussion and conclusion: Coronary syndromes are not frequent in morocco hemophilia patients. Their management is complex and involves the presence of an hematologist. VL - 3 IS - 4 ER -
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