title: Left anterior descending coronary artery spasm and "accordion effect" mimicking coronary artery dissection.
abstract: We present an illustrative case report of the mid-vessel left anterior descending (LAD) coronary artery spasm, which has been enhanced by straightening of the tortuous LAD segment with a guidewire ("accordion effect") thus resistant to intracoronary nitroglycerine and mimicking a coronary artery dissection. Dynamic appearance of this iatrogenic pseudo-lesion upon administration of intracoronary nitrates and recognition of these angiographic phenomena prevented from unnecessary further intervention.
authors.affiliation: Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: z.valuckiene@gmail.com.
authors.forename: Zivilė
authors.initials: Z
authors.lastname: Valuckienė
authors.affiliation: Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Tomas
authors.initials: T
authors.lastname: Vasylius
authors.affiliation: Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Ramūnas
authors.initials: R
authors.lastname: Unikas
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D003331:Coronary Vessels / Q000293:injuries*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D005996:Nitroglycerin / Q000008:administration & dosage; D015607:Stents / Q000009:adverse effects; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin
keywords: Accordion phenomenon; Coronary artery spasm; Percutaneous coronary intervention