Paradoxical coronary vasospasm and transient apical ballooning in a post-menopausal woman: An imaging case report of an unusual INOCA presentation

Abstract

Ischemia with non-obstructive coronary artery disease (INOCA), a common cause of angina, can occur due to coronary vasospasm, microvascular dysfunction, endothelial dysfunction, atherosclerosis or a combination of these mechanisms. We describe a case of adenosine-associated paradoxical coronary vasospasm and Takotsubo-like apical ballooning in a postmenopausal woman with underlying mild coronary atherosclerosis and microvascular dysfunction.