Coronary artery spasm-related acute coronary syndrome in patients with coexisting spasm of angiographically normal coronary artery and fixed narrowing of the remaining vessels.
Fourteen patients with acute coronary syndrome are presented in this study. During angiography, hemodynamically significant coronary artery disease was demonstrated; however, it was not consistent with the electrocardiographic findings. The coronary artery spasm could be provoked in the rest of the angiographically normal coronary artery. Patient chest pain disappeared after administration of calcium channel blockers and/or isosorbide dinitrite. It is suggested that (1) both coronary artery spasm with no fixed stenosis and coronary atherosclerosis with fixed coronary stenosis can coexist in the same patient and cause symptoms, and (2) it is important to identify the predominant cause of symptoms, which then guides correct management.
Yang
Ning-I
NI
Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung, Taiwan.
Hung
Ming-Jui
MJ
Cherng
Wen-Jin
WJ
D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000209:etiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging*; D014665:Vasodilator Agents / Q000627:therapeutic use
D002121:Calcium Channel Blockers; D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate