Familial catamenial coronary spasms

• Published in: BMJ case reports Vol. 17; no. 9
• Main Authors: de Groot, Elisabeth A A, van Heerebeek, Loek, Vink, Maarten A, Kuipers, Remko S
• Format: Journal Article
• Language: English
• Published: England 25-09-2024
• Subjects: Adult; Coronary Angiography; Coronary Vasospasm - complications; Coronary Vasospasm - diagnosis; Coronary Vasospasm - physiopathology; Electrocardiography; Female; Heart Failure - etiology; Heart Transplantation; Humans; Myocardial Infarction - diagnosis; Siblings; Vasodilator Agents - therapeutic use; Heart failure; Menopause (including HRT); Interventional cardiology; Estrogens; Arrhythmias
• ISSN: 1757-790X
• DOI: 10.1136/bcr-2024-260281

Coronary artery spasms represent important causes of myocardial ischaemia and infarction in patients with non-obstructive coronary artery disease. They are notably seen in younger people and occur almost equally in men and women. Besides traditional risk factors (ie, smoking), female hormones might also play a role.We report of two young sisters who presented with myocardial infarction caused by catamenial coronary spasms (CS), that is, during menstruation. In one of these women, this resulted in heart failure with a severely reduced ejection fraction and ultimately a heart transplant because of intractable ventricular arrhythmias.CS might result from changing hormone levels (especially oestrogen) during menstruation. Increased awareness of the occurrence of catamenial CS is essential for diagnosis and consequent treatment with coronary vasodilators and/or specific oestrogen/progesterone regimens.