A case of acute myocardial infarction due to coronary spasm in the myocardial bridge.
A 68-year-old Japanese man with acute inferior myocardial infarction underwent emergent coronary angiography which showed a myocardial bridge, but no coronary stenosis, at the infarctrelated artery. A spasm provocation test using intracoronary acetylcholine revealed a total occlusion due to severe spasm at the site of the myocardial bridge. Thus, the myocardial ischemia in this case was caused by the coronary spasm, but not by the limited flow due to the myocardial bridge. Although a beta-blocker is usually the appropriate drug, it should be avoided for coronary spasm. The spasm provocation test is useful to determine the type of medication needed for treatment.
Fujibayashi
Daisuke
D
Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan 259-1193.
Morino
Yoshihiro
Y
Ikari
Yuji
Y
D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology*; D013035:Spasm / Q000150:complications* / Q000503:physiopathology