Document Detail


Left main coronary artery spasm: a rare entity as a cause of myocardial infarction in a patient.
MedLine Citation:
PMID:  23388237     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Coronary artery disease (CAD) remains the major cause of mortality and morbidity in the United States despite significant advances for the prevention and treatment of CAD. Coronary artery spasm causing demand-supply mismatch with coronary ischemia can mimic CAD, resulting in unnecessary interventions. Left main coronary artery spasm, in particular, is a rare entity with only a few cases described in the literature. CASE PRESENTATION: A 49-year-old African-American female was evaluated at outpatient clinics for ongoing episodes of substernal chest pain which were then classified as atypical. Adenosine myocardial perfusion imaging study showed a small-size, mild-intensity, reversible ischemia in the anterior wall attributed to breast attenuation artifact. Medical management failed to relieve her chest pain and she was eventually referred for left heart catheterization. Angiography raised the suspicion of vasospasm and intracoronary nitroglycerin was injected, with resolution of the stenosis. CONCLUSION: There are multiple risk factors associated with coronary spasm. Although medical management, ie, vasodilators are the treatment of choice, cases refractory to medical therapy have been treated with coronary stenting and even coronary artery bypass graft surgery with acceptable outcomes.
Authors:
Fahad Ali; Haroon A Faraz; Muhammad Umer Siddiqui
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  25     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E36-8     Citation Subset:  IM    
Affiliation:
Heart & Vascular Institute, Harper Hospital, 4160 John R, Suite 510, Detroit, MI 48201 USA. siddiqi.umer@gmail.com.
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