Coronary spastic angina induced by adrenal insufficiency

Yuki Otsuka, Ko Harada, Miho Yasuda, Yasuhiro Nakano, Kou Hasegawa, Fumio Otsuka

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Adrenal insufficiency patients are treated with glucocorticoid replacement therapy. However, mimicking the in vivo circadian rhythm of cortisol levels is challenging, and suboptimal replacement increases the risk of mortality from cardiovascular disease. We herein report a case of coronary spastic angina (CSA) with simultaneous low early-morning serum cortisol levels in a patient undergoing corticosteroid replacement therapy for primary adrenal insufficiency. Steroid therapy is reportedly effective for refractory angina, but underlying adrenal deficiency has never been revealed. Our case intimates the probable risk of CSA as a complication of relative adrenal insufficiency and highlights the effectiveness of dexamethasone in these patients.

Original languageEnglish
Pages (from-to)1873-1877
Number of pages5
JournalInternal Medicine
Issue number15
Publication statusPublished - 2020


  • Adrenal insufficiency
  • Coronary vasospasm
  • Steroid replacement

ASJC Scopus subject areas

  • Internal Medicine


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