We report on a 74-year-old carcinoid patient who, following acute myocardia
l infarction (MI) and percutaneous transluminal coronary angioplasty, suffe
red recurrent episodes of chest pain and ST-segment elevation on ECG. This
was accompanied by elevation of urinary 5-hydroxy-indole acetic acid. A rev
iew of the patient's file revealed that during the 3 weeks prior to the MI,
she had been treated inadvertently with a fivefold lower dosage of octreot
ide. Following the correction of octreotide dosage, episodes of chest pain
resolved immediately. We therefore suggest that this patient suffered from
recurrent coronary vasospasm due to uncontrolled carcinoid tumour.