[Intimal coronary fibrous dysplasia and Prinzmetal's angina]

It is currently considered as exceptional for there to be arterial pathology other than atheroma in Prinzmetal angina. The authors have found five cases of coronary fibrous dysplasia in the literature. They add a case, in a woman, of intimal fibrous dysplasia diffusely involving the three main coronary vessels. Coronary arteriography showed that spasm of the right coronary artery was the cause of attacks with the clinical and electrocardiographic features of Prinzmetal angina. The whole coronary tree was otherwise normal angiographically and also macroscopically at autopsy. The dysplasia was only discovered by histological study of serial sections of the three coronary vessels. Histological examination showed no evidence of an atheromatous lesion. The authors place these coronary artery lesions within the general classification of arterial fibrous dysplasias. It remains hypothetical whether there is a relationship between the occurrence of spasm and this very special histological feature of the coronary artery wall.