胸痛を伴う一過性ST低下を呈したCushing症候群の1例

Abstract

We report a 57-year-old woman with Cushing's syndrome showing tran- sient ST depression probably due to coronary vasospasm. She was referred to a private hospital because of flush and sweating. The diagnosis of Cushing's syndrome was made after further evaluation. She was admitted to our hospital for the surgical treatment of an adrenal tumor. During the preoperative period, anterior chest oppression appeared with ST depression on electrocardiogram. Emergency cardiac catheterization showed no significant coronary artery stenosis, but intra-coronary administration of isosorbide dinitrate im- proved both chest symptoms and ischemic changes on electrocardiogram. After the successful resection of the adrenal tumor which proved to be an adrenal cancer, she had no chest symptom at all. This suggests that serum cortisol in excess might induce vasospasm of small coronary arteries in Cushing's syndrome.