[Threatened extension of myocardial infarction in situ and coronary spasm].
The authors report a case of threatened spread occurring 4 days after posterior-inferior myocardial infarction and involving the same territory. The spontaneous occurrence during coronary angiography of an occlusive spasm of the right coronary artery with recurrence of angina and ST elevation in the area of initial necrosis suggests that this mechanism might be the contributory factor to the threat of in situ spread. Thus intermittent coronary occlusion from repeated spasm can bring about incomplete necrosis of the area of dependent myocardium and by extension threaten the viability of groups of still healthy cells. A syndrome of this kind initially requires coronary-dilating medical treatment, with nitrate derivatives and calcium inhibitors and then early coronary angiography with the use of pharmacodynamic tests to assess the suitability of surgery.
D000328:Adult; D000787:Angina Pectoris / Q000209:etiology*; D000789:Angina, Unstable / Q000209:etiology*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology; D012008:Recurrence
Menace d'extension d'infarctus du myocarde in situ et spasme coronarien.