VASOSPASTIC ANGINA INDUCED BY NONSTEROIDAL ANTIINFLAMMATORY DRUGS

We report two cases of vasospastic angina associated with anaphylactic reaction caused by nonsteroidal antiinflammatory drugs (NSAIDs). Both patients exhibited anaphylactic manifestations, such as general rash and urticaria, along with angina pectoris with electrocardiographic ST -segment elevations after suppository administration of diclofenac sod ium or indomethacin, the most commonly used NSAIDs. Although these pat ients had normal coronary arteriograms, intracoronary administration o f ergonovine or acetylcholine provoked diffuse coronary artery spasms accompanied by chest pain and ischemic ST-segment changes. It is there fore suggested that an allergic mechanism may be involved as a causati ve factor of the coronary artery spasm induced by NSAIDs.