A Painful Sleep Apnea

Abstract

Background: Obstructive sleep apnea (OSA) is largely recognized as an independent risk factor for coronary artery disease (CAD), its prevalence is higher in the acute phase of ischemic heart disease and the risk of developing ischemic myocardial injury is greater in presence of this syndrome. OSA seems to exacerbate ischemic nocturnal events, to impair coronary blood flow (CBF) response to myocardial energy demand, to increase myocardial vascular resistance and to negatively impact outcomes of percutaneous coronary intervention (PCI) Case report: We reported the case of 57-years-old men with multiples cardiovascular risk factors and previous history of severe CAD, who presented multiples relapses of in-stent restenosis and failure in percutaneous procedures; because of overweight, snoring and nocturnal pains referred occurring simultaneously of respiratory apneic events, he underwent to an overnight sleep screening, resulting positive for obstructive sleep apnea. Conclusions: OSA, likewise others chronic inflammatorystates, could be responsible for negative outcomes of PCI(in-stent proliferation restenosis) due to abnormal inflammatory state, coronary microvascular dysfunction secondary to vascular remodeling, and thusineffectiveness of coronary blood flow (CBF) response to myocardial work.