Clinical and angiographic characteristics of acute myocardial infarction caused by vasospastic angina without organic coronary heart disease.
BACKGROUND
Vasospastic angina (VA) can occasionally cause acute myocardial infarction (AMI).


RESULTS
From January 2003 to June 2005, coronary spastic angina was diagnosed in 292 patients by performing spasm provocation tests. Among the 292 patients, 21 (7.2% of all the VA patients) had an AMI. There were 20 patients who initially visited the emergency room for AMI without suffering prior VA. One patient with a history of VA had an AMI when he discontinued his medication. Among the 21 VA patients with AMI, 14 had experienced severe emotional stress before they visited the emergency room. The spasm provocation test showed that the VA patients with AMI had more multivessel and diffuse spasm than the VA patients without AMI (p<0.001).


CONCLUSIONS
Clinically, the VA patients with AMI usually had their first symptom of VA as the severe chest pain of AMI. Two-thirds of the VA patients with AMI had experienced emotional stress before their AMI. Angiographically, the spasm provocation test for VA patients with AMI showed more multivessel and diffuse spasm than in VA patients without AMI.
Kim
Pum Joon
PJ
Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Seung
Ki-Bae
KB
Kim
Dong-Bin
DB
Her
Sung-Ho
SH
Shin
Dong-Il
DI
Jang
Seong-Wong
SW
Park
Chan-Seok
CS
Park
Hoon-Joon
HJ
Jung
Hae-Ok
HO
Baek
Sang Hong
SH
Kim
Jae-Hyung
JH
Choi
Kyu-Bo
KB
D000208:Acute Disease; D000328:Adult; D000787:Angina Pectoris / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease; D003329:Coronary Vasospasm / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D013315:Stress, Psychological / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology