Document Type : Case Report
Authors
1 Assistant Professor, Department of Cardiology, School of Medicine, Qom University of Medical Sciences, Qom, Iran
2 Researcher AND General Practitioner, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
Abstract
BACKGROUND: Coronary artery spasm (CAS) can result in life-threatening arrhythmia and sudden cardiac death. Although this disorder has been known for a long time, little is known about it, and its mechanisms have been not identified yet.CASE REPORT: We describe a 52-year-old woman with no significant cardiovascular risk factors who experienced several episodes of spontaneous and coincident multivessel coronary artery spasm, which led to myocardial infarction as well as malignant arrhythmias. Coronary angiography revealed severe migratory narrowing in the left anterior descending artery and right coronary artery.CONCLUSION: Simultaneous multivessel coronary artery spasm develop multisite myocardial infarction (MI), and malignant arrhythmias could occur even in the absence of significant stenosis and triggering factors, which would lead to an increased risk of life-threatening cardiac events.
Keywords
- MacAlpin RN. Some observations on and controversies about coronary arterial spasm. Int J Cardiol 2015; 181: 389-98.
- Kusama Y, Kodani E, Nakagomi A, Otsuka T, Atarashi H, Kishida H, et al. Variant angina and coronary artery spasm: The clinical spectrum, pathophysiology, and management. J Nippon Med Sch 2011; 78(1): 4-12.
- de Luna AB, Cygankiewicz I, Baranchuk A, Fiol M, Birnbaum Y, Nikus K, et al. Prinzmetal angina: ECG changes and clinical considerations: A consensus paper. Ann Noninvasive Electrocardiol 2014; 19(5): 442-53.
- Hung MJ, Hu P, Hung MY. Coronary artery spasm: Review and update. Int J Med Sci 2014; 11(11): 1161-71.
- Falsoleiman H, Bayani B, Dehghani M, Moohebati M, Rohani A. Global coronary arteries spasm in a young patient. ARYA Atheroscler 2013; 9(4): 260-2.
- O'Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013; 61(4): e78-140.
- Chuang YT, Ueng KC. Spontaneous and simultaneous multivessel coronary spasm causing multisite myocardial infarction, cardiogenic shock, atrioventricular block, and ventricular fibrillation. Circ J 2009; 73(10): 1961-4.
- Hendriks ML, Allaart CP, Bronzwaer JG, Res JJ, de Cock CC. Recurrent ventricular fibrillation caused by coronary artery spasm leading to implantable cardioverter defibrillator implantation. Europace 2008; 10(12): 1456-7.
- Hovasse T, Jariwala P, Lefevre T. Spontaneous coronary artery spasm during-įcoronary angiography: An uncommon manifestation of variant angina. Journal of Indian College of Cardiology 2015; 5(1): 103-6.
- Chu G, Zhang G, Zhang Z, Liu S, Wen Q, Sun B. Clinical outcome of coronary stenting in patients with variant angina refractory to medical treatment: A consecutive single-center analysis. Med Princ Pract 2013; 22: 583-7.
)