Search

The role of magnesium in coronary artery disease has been evaluated extensively during the last three decades. The intravenous application of magnesium in acute coronary syndromes is of major importance, the beneficial effects of magnesium in acute myocardial infarction have been underlined in several studies. The promising results of LIMIT-2 could not be confirmed by the data of ISIS-4. A world-wide, multicenter trial (MAGIC) has been set up in order to evaluate the optimal patient cohort as well as the ideal dose regimen for the application of intravenous magnesium in patients with acute MI. Furthermore, magnesium is of significance in the pathomechanism of reperfusion injury and reduction of malign arrhythmia in the critical acute phase of MI, if applied intravenously. In stable coronary artery disease oral magnesium therapy has proven beneficial effects too.

In a 43-year-old woman with ECG changes of an acute anterior and posterior wall infarct, associated symptoms and biochemical findings, coronary angiography demonstrated normal coronary arteries and a normal variant in the course of the left coronary artery. Vasospasms in another vascular bed (migraine) and highly positive 201-Thallium scintigraphy during acral cold provocation speak for coronary spasm as cause of the myocardial ischaemia in this patient.