Coronary Artery Spasm

Abstract

HomeCirculationVol. 113, No. 14Coronary Artery Spasm Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBCoronary Artery Spasm Vinod Raxwal, MD and Kamal Gupta, MD Vinod RaxwalVinod Raxwal From Kansas University Medical Center, Kansas City, Kan. Search for more papers by this author and Kamal GuptaKamal Gupta From Kansas University Medical Center, Kansas City, Kan. Search for more papers by this author Originally published11 Apr 2006https://doi.org/10.1161/CIRCULATIONAHA.105.581678Circulation. 2006;113:e689–e690A 50-year-old male patient presented with severe chest pain and right arm tightness. On arrival, he was hypotensive and had an initial slow atrial fibrillation with acute ST-segment elevation across the anterior and inferior leads (Figure 1). This required external pacing as well as atropine. The patient underwent urgent diagnostic coronary angiography that revealed a severely diseased, small-caliber right coronary artery with 100% distal cutoff before its bifurcation (Figure 2); 25% distal left main coronary artery stenosis with a diffusely diseased left anterior descending coronary artery from the ostium to the apex; and a circumflex artery with 50% proximal stenosis (Figure 3). Intracoronary nitroglycerin and nicardipine were injected, which resulted in complete resolution of stenosis (Figure 4 and Figure 5). The ST-segment elevation on the ECG subsequently resolved, and the patient returned to sinus rhythm. The patient had a peak troponin value of 0.29 and preserved left ventricular function with no wall motion abnormalities. Download figureDownload PowerPointFigure 1. ECG showing ST-segment elevation.Download figureDownload PowerPointFigure 2. Angiogram of the right coronary artery.Download figureDownload PowerPointFigure 3. Angiogram of the left coronary artery.Download figureDownload PowerPointFigure 4. Angiogram of the right coronary artery after vasodilator administration.Download figureDownload PowerPointFigure 5. Angiogram of the left coronary artery after vasodilator administration.DisclosuresNone.FootnotesCorrespondence to Vinod Raxwal, MD, Kansas University Medical Center, 3901 Rainbow Blvd, 1001 Eaton Bldg, MS 3006, Kansas City, KS 66212. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Quader N and Wilansky S (2015) Women and Coronary Artery Disease Coronary Artery Disease, 10.1007/978-1-4471-2828-1_7, (167-180), . April 11, 2006Vol 113, Issue 14 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.105.581678PMID: 16606795 Originally publishedApril 11, 2006 PDF download Advertisement SubjectsImagingMyocardial Infarction