Vasospastic angina mimicking graft failure and spontaneously appearing after left ventriculography.
A 49-year-old female with significant (75%) left main coronary artery stenosis was initially considered to have developed early obstruction of a saphenous vein graft to the left anterior descending coronary artery, because of recurrent postoperative angina. In a second catheterization study, left ventriculography showed normal contractility of all segments and was immediately followed by the onset of angina and angiographic demonstration of diffuse spasm of the entire left coronary artery system beyond the stenosis. Vasospasm of the left coronary artery before or during ventriculography was unlikely in the absence of regional contractility impairment. The close temporal association between the left ventricular angiogram and the angiographic demonstration of vasospasm suggested a direct cause and effect relationship.
D000790:Angiocardiography / Q000009:adverse effects*; D001026:Coronary Artery Bypass; D003329:Coronary Vasospasm / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged