title: Coronary spasm as the cause of myocardial ischaemia in a patient with anomalous origin of the left anterior descending artery from the proximal right coronary artery.
abstract: A 49-year-old woman developed angina at rest. A CT of the coronary artery revealed that the left anterior descending artery arose from the right coronary artery, and traversed between the aorta and pulmonary trunk. An exercise stress myocardial scintigraphy did not reproduce myocardial ischaemia or anginal symptoms. A coronary angiography did not show any atherosclerotic changes. Finally, an ergotamine provocation test for vasospasm revealed diffuse severe spasm in the right coronary artery and the left anterior descending artery. Surgical correction of the anomaly was deferred and the patient was managed with medications to control spasm with good clinical outcome.
authors.affiliation: Department of Cardiology, Okinawa Chubu Hospital, Uruma, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakazato
authors.affiliation: Department of Cardiology, Okinawa Chubu Hospital, Uruma, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Hirata
authors.affiliation: Department of Cardiology, Okinawa Chubu Hospital, Uruma, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Wake
mesh_terms: D003329:Coronary Vasospasm / Q000150:complications*; D003330:Coronary Vessel Anomalies / Q000150:complications*; D004417:Dyspnea / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology*; D014057:Tomography, X-Ray Computed