[Prinzmetal angina after licorice consumption]. 2015

Kathrin Machalke, and Peter Bramlage, and Karin Bramlage, and Ulrich Tebbe
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Klinikum Lippe GmbH, Detmold.

Medical history | We report on a 44-year-old patient with recurrent thoracic pain occurring 4 months apart. The patient complained about intense thoracic pain and acute dyspnoea in the morning. In the course of the second presentation the anamnesis revealed that the previous day the patient had consumed an entire bag of licorice (200 g). Investigations | The blood pressure was 90/65 mmHg, heart rate 68 beats / min. Neither the performed ECG nor the transthoracic echocardiography showed abnormalities. The blood tests revealed elevated troponin levels only. No coronary artery stenosis was evident on left heart catheterization. After 4 months- the symptoms reappeared- the blood pressure was 110/50 mmHg. An ECG showed infarct-typical ST elevations. The performed coronary angiography showed no stenosis or embolism. Intracoronary nitro administration resulted in significant vasodilatation. After 6 hours in the control- ECG the ST elevations were missing. We diagnosed a Prinzmetal angina. Treatment and course | The patient was given advice not to consume licorice in the future. Her medication was adjusted to 2.5 mg amlodipine per day. There has been no further presentation with similar symptoms since then. Conclusion | Case reports provide evidence of unknown potential side- effects concerning well-known medical plants or substances. It is already known that the ingredients of licorice may induce hypertension. Potential spastic reactions, such as a Prinzmetal angina, due to the possible cardiac effects caused by glycyrrhizin and glycyrrhetinic acid are rare side effects of licorice ingestion.

UI MeSH Term Description Entries
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D005517 Foodborne Diseases Acute illnesses, usually affecting the GASTROINTESTINAL TRACT, brought on by consuming contaminated food or beverages. Most of these diseases are infectious, caused by a variety of bacteria, viruses, or parasites that can be foodborne. Sometimes the diseases are caused by harmful toxins from the microbes or other chemicals present in the food. Especially in the latter case, the condition is often called food poisoning. Food Poisoning,Food-borne Disease,Food-borne Illness,Foodborne Disease,Foodborne Illness,Food-borne Diseases,Food-borne Illnesses,Foodborne Illnesses,Poisoning, Food,Disease, Food-borne,Disease, Foodborne,Food Poisonings,Food borne Disease,Food borne Diseases,Food borne Illness,Food borne Illnesses,Illness, Food-borne,Illness, Foodborne,Illnesses, Foodborne
D006035 Glycyrrhiza A genus of leguminous herbs or shrubs whose roots yield GLYCYRRHETINIC ACID and its derivative, CARBENOXOLONE. Licorice,Glycyrrhiza glabra,Liquorice,Licorices,Liquorices
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000788 Angina Pectoris, Variant A clinical syndrome characterized by the development of CHEST PAIN at rest with concomitant transient ST segment elevation in the ELECTROCARDIOGRAM, but with preserved exercise capacity. Prinzmetal Angina,Prinzmetal's Angina,Angina, Prinzmetal,Angina, Prinzmetal's,Prinzmetals Angina,Variant Angina Pectoris
D014665 Vasodilator Agents Drugs used to cause dilation of the blood vessels. Vasoactive Antagonists,Vasodilator,Vasodilator Agent,Vasodilator Drug,Vasorelaxant,Vasodilator Drugs,Vasodilators,Vasorelaxants,Agent, Vasodilator,Agents, Vasodilator,Antagonists, Vasoactive,Drug, Vasodilator,Drugs, Vasodilator
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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