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Old 08-11-2011
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Default migraine with chest pain

A patient taking sumatriptan for migraine headaches develops angina. This mechanism for this type of angina is similar to that seen:
A. A patient with aortic steonsis
B. A patient with hypercholesterolemia
C. A patient with gastric reflux
D. A patient with deep venous thrombus
E. A patient with history of cocaine abuse
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Old 08-11-2011
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Old 08-11-2011
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is it e? increases sympathic stimulation?
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Old 08-11-2011
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Yea, I think its E since it prevents NE reuptake = vasoconstriction = angina.
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Old 08-12-2011
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Old 08-12-2011
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Correct Answer

The correct answer is E.
Sumatriptan, like cocaine, can cause coronary artery vasospasms. Unlike coronary artery disease associated with atherosclerosis or thrombosis, there is no intra-arterial occlusion in vasospasms. Patients with aortic stenosis usually have decreased diastolic flow as a result of high LVEDP, with resulting compromise of coronary blood flow causing angina. In reflux, the angina symptom is from stimulation of visceral afferents which innervate the gastric walls.
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