PDF(Pubmed)
Abstract：
We present a case of pyridostigmine-induced coronary artery spasm in a woman with early-onset myasthenia gravis (MG) who suffered from acute chest discomfort a few days after pyridostigmine dose up-titration. Twelve-lead ECG demonstrated ST-segment elevation in inferior limb leads together with sinus arrest. Sublingual nitrate was immediately given, which rapidly relieved her symptoms concomitantly with the resolution of abnormal ECG findings. Coronary angiography showed normal coronary arteries reflecting the transient nature of the disease. A small dose of pyridostigmine was rechallenged under close monitoring in the coronary care unit and reproduced her chest discomfort. After the substitution of pyridostigmine with immunosuppressive agents and prescription of long-acting nitrate, she had no recurrence of chest discomfort, as well as well-controlled MG symptoms.
摘要：
我们介绍了一例早发性重症肌无力（MG）女性的吡啶斯的明引起的冠状动脉痉挛，该女性在吡啶斯的明剂量上调后几天遭受急性胸部不适。十二导联心电图显示下肢导联ST段抬高并伴有窦性停搏。立即给予舌下硝酸盐，这迅速缓解了她的症状，同时解决了异常的心电图发现。冠状动脉造影显示正常的冠状动脉反映了该疾病的短暂性质。在冠状动脉监护病房的密切监测下，小剂量的吡啶斯的明被再次挑战，并重现了她的胸部不适。用免疫抑制剂代替吡啶斯的明并处方长效硝酸盐后，她没有复发胸部不适,以及控制良好的MG症状。
