Abstract
Coronary artery spasm is usually defined as a focal constriction of a coronary artery segment, which is reversible, and causes myocardial ischaemia by restricting coronary blood flow. A coronary spasm may rarely compromise all three epicardial arteries simultaneously. We present a case of severe coronary spasm afflicting all coronary arteries accompanying an ST segment elevation in leads D2-D3 and aVF.
Highlights
Coronary artery vasospasm is an important cause of myocardial ischaemia
Diffuse significant narrowing was detected in the left anterior descending (LAD) artery and both proximal and distal to the stent in the Cx artery, but no instent stenosis was detected (Figure 2)
We thought that the subtotal lesion in the distal right coronary artery (RCA) was the culprit lesion, so a right guiding catheter was seated to the right coronary ostium
Summary
Coronary artery vasospasm is an important cause of myocardial ischaemia. Chest pain after successful percutaneous coronary intervention constitutes a considerable problem and is potentially life threatening when myocardial ischaemia occurs. Such pain indicates the presence of residual coronary stenosis, acute occlusion, coronary spasm, or myocardial infarction. Diffuse significant narrowing was detected in the LAD artery and both proximal and distal to the stent in the Cx artery, but no instent stenosis was detected (Figure 2).
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