title: Premenopausal woman with acute myocardial infarction caused by spontaneous coronary artery dissection and potential association with coronary vasospasm.
abstract: A 45-year-old premenopausal woman presented with acute myocardial infarction (MI). An intravascular ultrasound (IVUS) revealed that her distal right coronary artery was occluded by spontaneous coronary artery dissection (SCAD). She did not have any specific condition related to SCAD. At follow-up cardiac catheterization, an acetylcholine provocation test was applied to examine the etiology of SCAD, and definitive coronary vasospasm was induced with chest symptoms and significant electrocardiographic change. A Ca-channel blocker was administered and since then chest pain has subsequently so far been relieved. The current case suggests the significance of the IVUS in detecting etiology of MI in younger patients and the potential association between SCAD and coronary vasospasm.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. tsujita@kumamoto-u.ac.jp
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tsujita
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Kaikita
authors.forename: Tadasuke
authors.initials: T
authors.lastname: Chitose
authors.forename: Naoko
authors.initials: N
authors.lastname: Takaoka
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Soejima
authors.forename: Shinji
authors.initials: S
authors.lastname: Tayama
authors.forename: Seiji
authors.initials: S
authors.lastname: Hokimoto
authors.forename: Seigo
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017697:Premenopause; D018084:Ultrasonography, Interventional; D014652:Vascular Diseases / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery