Abstract
Background: Non-atherosclerotic processes are regarded as equally important contributors to a substantial number of coronary problems mainly myocardial infarction. This includes coronary spasm which has been considered as one of the coronary syndromes leading to myocardial infarction. These non-atherosclerotic events ensuing in major averse cardiac events (MACE) not only require various diagnostic and therapeutic strategies but also there is a need to delineate the underlying etiology for their effective treatment and management. Case Summary: We report a case of anterior wall myocardial infarction (AWMI) driven by a non-atherosclerotic event i.e. coronary spasm. Concomitant marked ST-segment elevation recorded on ECG revealed a diffuse mid distal disease in our patient. We report here the initial presentation, coronary care & intervention and throughout the clinical course of our patient. Conclusion: Myocardial infarctionsinvolving non-atherosclerotic causes in young individuals as in our study should be reported by medical practitioners and given equal importance as they might indicate the underlying root cause of such events. Effective treatment of such future cases can be done by taking management strategies, diagnostic findings and prognostic data into consideration.
Highlights
Myocardial infarction (MI) is one of the leading causes of mortality and morbidity worldwide
It is reportedly said to occur between 40 and 70 years and is not a much common event among individuals lesser than the reported age [5]. In this case report we highlight and discuss Coronary Artery Spasm (CAS) as a non-atherosclerotic event in an early thirty male patient presented with ST-elevation myocardial infarction (STEMI) or AWMI on diagnosis
Our patient was treated with intracoronary nitroglycerin intervention and many studies highlight the importance of administration of intracoronary nitrates during diagnostic coronary angiography before percutaneous coronary intervention (PCI)
Summary
Myocardial infarction (MI) is one of the leading causes of mortality and morbidity worldwide. Coronary Artery Spasm (CAS) or Coronary Vasospasm is a critical non-atherosclerotic event that if not treated promptly can progress to a deadly condition like MI or even sudden death. It is characterized as the sudden, intense vasoconstriction of an epicardial coronary artery that may result in partial or complete vessel occlusion [3]. It is reportedly said to occur between 40 and 70 years and is not a much common event among individuals lesser than the reported age [5] In this case report we highlight and discuss CAS as a non-atherosclerotic event in an early thirty male patient presented with ST-elevation myocardial infarction (STEMI) or AWMI on diagnosis. Lab for immediate primary percutaneous coronary intervention (PCI) His vitals at presentation were: BP=100/60mmHg, Pulse=100/min, SaO2=98%. He had no active complaints, did not require any hospital admission and his condition was controlled and stabilized by medical management
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