title: A change in the pattern of vasospasm after stenting in a patient with vasospastic angina.
abstract: We report an unusual case of a male patient with vasospastic angina in whom the pattern of coronary artery spasm changed after coronary stenting. The patient was admitted to our hospital with an acute coronary syndrome. Coronary angiography revealed an intermediate grade stenosis in the right coronary artery, and focal coronary spasm was provoked by intracoronary acetylcholine. A diagnosis of vasospastic angina was made, and the patient was followed medically. He subsequently was readmitted with refractory vasospastic angina and underwent coronary stenting. He was pain-free after stent implantation. Repeat angiography 6 months later showed no restenosis in the stented segment; however, coronary spasm was provoked in all areas except the stented segment by intracoronary acetylcholine injection.
authors.affiliation: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan. wadamasamichi@hotmail.com
authors.forename: Masamichi
authors.initials: M
authors.lastname: Wada
authors.forename: Hisao
authors.initials: H
authors.lastname: Hara
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000109:Acetylcholine; D000788:Angina Pectoris, Variant / Q000209:etiology*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*
chemical_list: D000109:Acetylcholine