Coronary artery spasm associated with a moderately severe atherosclerotic stenosis in the proximal LAD.
Treatment of coronary artery spasm can be difficult; up to 25% of patients continue to have episodes of chest pain despite maximal therapy with calcium antagonists and nitrates. We describe the case of a 42-year-old female with severe coronary artery spasm associated with a moderately severe atherosclerotic stenosis of the proximal left anterior descending coronary artery. We discuss the diagnostic value of intravascular ultrasound and treatment options for spasm associated with atherosclerotic plaques.
Ashby
Dale T
DT
Cardiovascular Research Foundation, Lenox Hill Heart and Vascular Institute, New York, New York 10022, USA.
Conditt
Gerard
G
Hirose
Makoto
M
Dangas
George
G
D000328:Adult; D001241:Aspirin / Q000008:administration & dosage; D000069059:Atorvastatin; D006328:Cardiac Catheterization / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003329:Coronary Vasospasm / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D004110:Diltiazem / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage; D006801:Humans; D007547:Isosorbide / Q000008:administration & dosage; D011758:Pyrroles / Q000008:administration & dosage; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin; D004110:Diltiazem; D001241:Aspirin; D007547:Isosorbide