Key result
Monozygotic identical twin brothers presented almost simultaneously with vasospastic angina and similar coronary artery anatomy, highlighting the importance of genetic factors in its pathogenesis.
Case Report (n=2)
No
This case report highlights the potential importance of genetic factors in the pathogenesis of vasospastic angina, suggesting that identical twins of affected individuals may warrant medical attention.
May warrant evaluation of identical twins; hypothesis-generating for genetic factors and needs confirmation in larger studies.
BACKGROUND: The clinical conditions of various diseases, including coronary artery disease, are determined by genetics and the environment. Previous investigations noted the significance of genetic mutations and polymorphisms in cases of coronary spasm. CASE REPORT: We report on monozygotic identical twins who almost simultaneously presented with vasospastic angina. The 58-year-old younger twin was admitted to our hospital because of persistent chest pain. An electrocardiogram showed an inverted T wave in the left precordial leads. Coronary angiographies revealed a short left main trunk (LMT) and 50% stenosis at the proximal portion of the left anterior descending artery (LAD). Infusion of acetylcholine to his left coronary artery caused marked vasoconstriction associated with a sensation of chest oppression. Nitroglycerine completely reversed this response. Based on these findings, we diagnosed Twin A with vasospastic angina. At nearly the same time, his identical twin brother was diagnosed with vasospastic angina at another hospital. Comparison of both coronary angiograms indicated similar structure of coronary vessels, including short LMT and mild stenosis at the proximal portion of LAD. CONCLUSIONS: These 2 cases highlight the importance of genetic factors in the pathogenesis of vasospastic angina. It may be important for individuals to receive medical attention if their identical twin presents with vasospastic angina.
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Yoshioka et al. (2015) conducted a case report in Vasospastic angina (n=2). Monozygotic twin status was evaluated on Concordance of vasospastic angina and coronary anatomy. Monozygotic identical twin brothers presented almost simultaneously with vasospastic angina and similar coronary artery anatomy, highlighting the importance of genetic factors in its pathogenesis.
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