title: ST-elevation myocardial infarction secondary to coronary artery spasm provoked by food.
abstract: We describe a patient with recurrent episodes of inferior ST elevation, secondary to coronary artery spasm. Each episode appeared to be provoked by the ingestion of rice and accompanied by a troponin T rise. An inpatient coronary angiogram immediately following an episode of pain demonstrated a focal area of spasm affecting the right coronary artery, which resolved with intracoronary nitrate injection. Although these episodes were self-limiting, cardiac MRI confirmed an acute subendocardial infarct. An association between food substances and coronary artery spasm with subsequent infarction has not been documented previously. Following appropriate advice and titration of antispasmodic medication, the patient has been pain free.
authors.affiliation: Department of Cardiology, NHS, London, UK.
authors.forename: William
authors.initials: W
authors.lastname: Young
authors.affiliation: Royal Gwent Hospital, Newport, UK.
authors.forename: Rai
authors.initials: R
authors.lastname: Bhichhyan
authors.affiliation: Basildon Hospital, Basildon, UK.
authors.forename: Alamgir
authors.initials: A
authors.lastname: Kabir
authors.affiliation: Department of Cardiology, Royal Brompton Hospital, London, UK.
authors.forename: Wajid
authors.initials: W
authors.lastname: Hussain
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications* / Q000188:drug therapy; D003331:Coronary Vessels / Q000473:pathology*; D004435:Eating; D005502:Food; D006329:Heart Conduction System / Q000002:abnormalities*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology* / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D010276:Parasympatholytics / Q000627:therapeutic use; D013035:Spasm; D020107:Troponin T / Q000097:blood
chemical_list: D010276:Parasympatholytics; D020107:Troponin T