NYMC Faculty Publications

Acute Coronary Syndrome Due to Coronary Vasospasm: A Case Report

Author Type(s)

Resident/Fellow, Faculty

DOI

10.1080/14796678.2024.2392995

Journal Title

Future Cardiology

First Page

613

Last Page

618

Document Type

Article

Publication Date

1-1-2024

Department

Medicine

Keywords

acute coronary syndrome, case report, chest pain, coronary vasospasm, ischemia with nonobstructive coronary arteries, myocardial infarction, myocardial perfusion, prinzmetal angina, vasospastic angina, Wenckebach phenomena

Disciplines

Medicine and Health Sciences

Abstract

Coronary vasospasm can lead to decreased cardiac perfusion and result in acute coronary syndrome. Here is a case of a 49-year-old man presented to the emergency department with epigastric pain and nausea with normal initial electrocardiogram. However, 6 h later, the patient experienced severe chest pain prompting a repeat electrocardiogram demonstrating inferior ST-segment elevation with troponin I levels peaked at 1.2 ng/ml (normal range: 0.00–0.02 ng/ml). Coronary angiography revealed angiographic stenosis in the left circumflex territory of a left dominant system which resolved with intracoronary nitroglycerin administration indicating ischemia with nonobstructive coronary arteries secondary to coronary vasospasm. He was discharged on isosorbide mononitrate and amlodipine therapy and had no recurrence of symptoms during follow-up.

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