Coronary artery pain. A possible cause of graft occlusion in a patient with fixed obstructive coronary artery disease.
We describe a 50-year-old man with rest angina and ECG anterior wall subendocardial ischemia. During coronary angiography, a high-grade proximal left anterior descending stenosis was present. Spontaneous total spasm distal to the lesion occurred without chest pain or ST segment shifts. The patient underwent aortocoronary bypass surgery and continued to have the same pain as preoperatively. Repeated catheterization demonstrated total occlusion of the bypass graft with unchanged native coronary vessels. This suggests prolonged coronary artery spasm as the mechanism for graft occlusion.
D000788:Angina Pectoris, Variant / Q000150:complications; D001157:Arterial Occlusive Diseases / Q000209:etiology*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013035:Spasm / Q000150:complications*