Isolated coronary ostial stenosis associated with coronary vasospasm.
A 50-year-old woman was brought to the emergency room in a preshock condition. An emergency coronary angiogram revealed 90% ostial stenosis of the left coronary artery with delayed distal filling. After intracoronary nitrate, the degree of stenosis was reduced to 75%; no other coronary lesions were evident. The patient was found to have hyperthyroidism and she became euthyroid after a 2-month regimen of methimazole. A follow-up coronary angiogram showed that the left coronary artery had 50% ostial stenosis without delayed distal filling. At the same time, an aortogram showed complete occlusion of the right subclavian artery in its proximal site, a slight dilatation of the truncus brachiocephalic artery, and a diffuse wall irregularity of the abdominal aorta, suggestive of Takayasu's arteritis.
Arima
M
M
Department of Internal Medicine, Juntendo Urayasu Hospital, Juntendo University School of Medicine, Chiba, Japan.
Kanoh
T
T
Kawano
Y
Y
Okazaki
S
S
Oigawa
T
T
Yamagami
S
S
Matsuda
S
S
D003327:Coronary Disease / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D003329:Coronary Vasospasm / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009566:Nitrates / Q000008:administration & dosage / Q000494:pharmacology; D013625:Takayasu Arteritis / Q000150:complications
D009566:Nitrates