Table 1

Literature review of pyridostigmine-induced coronary artery spasm

AuthorAge/sexMG classificationUnderlying diseasePyridostigmine (mg/day)ECG finding/
cardiac marker
Comerci, et al175/FAChR Ab: NA
Generalised MG
  • Pulmonary embolism

  • Smoking

  • Anterolateral STE

  • Peak CK-MB mass 12.52 ng/mL

Diffuse reversible vasospasm of LADNo recurrent
Zis, et al288/FAChR Ab: positive
Generalised MG
  • Thymoma

  • Smoking

  • STE in V1–V2 and T-wave abnormalities

  • Trop T 200 pg/mL (normal < 14 pg/mL)

30% LAD stenosisNo recurrent
Barista, et al331/FNANoNA
  • Septal STD

  • Trop I 2.91/3.36 (normal < 0.05)

Niazi, et al488/FAChR Ab: positive
Generalised MG
  • Lung cancer

  • Paroxysmal AF

  • Diffuse STE

70% LAD stenosisNA
Present case40/FAChR Ab: positive
Generalised MG
  • Hypertension

  • Asthma

  • STE in II, III and aVF with reciprocal STD in I and aVL

  • Sinus arrest with junctional escape

  • hs-Trop I 72 ng/L

NormalNo recurrent
  • AChR Ab, antiacetylcholine receptor antibody; AF, atrial fibrillation; CAG, coronary angiography; CK-MB, creatine kinase-MB; ECG, electrocardiography; F, female; hs-Trop, high-sensitivity troponin; LAD, left anterior descending; MG, myasthenia gravis; NA, not applicable; STD, ST-segment depression; STE, ST-segment elevation; Trop, troponin.