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04:30

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[A case of coronary vasospasm treated with stent placement]

M Maeder1, P Ammann, W Angehrn

  • 1Departement Innere Medizin, Fachbereich Kardiologie, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland.

Zeitschrift Fur Kardiologie
|February 22, 2003
PubMed

Insights

A 49-year-old woman experienced chest pain and ECG changes during hyperventilation, revealing coronary artery stenosis. Treatment resolved symptoms, highlighting hyperventilation

Area of Science:

  • Cardiology
  • Diagnostic Testing
  • Interventional Cardiology

Background:

  • Coronary artery disease can manifest with varied symptoms, including chest pain at rest.
  • The interplay between fixed atherosclerotic lesions and coronary vasospasm requires further elucidation.

Observation:

  • A 49-year-old woman presented with recurrent chest pain at rest.
  • Hyperventilation induced significant ST-segment elevation in anterior leads (V1-V5).
  • Standard bicycle stress testing did not elicit electrocardiogram (ECG) changes.

Findings:

  • Coronary angiography identified significant stenosis in the left anterior descending coronary artery.
  • Successful balloon angioplasty and stent implantation resolved the obstructive lesion.
  • Post-intervention, hyperventilation no longer provoked chest pain or ECG abnormalities without antispastic medication.

Implications:

  • Hyperventilation may serve as a valuable non-invasive provocation test for coronary vasospasm, particularly in the presence of underlying atherosclerotic disease.
  • Understanding the impact of fixed lesions on vasospasm dynamics is crucial for comprehensive patient management.
  • Therapeutic strategies targeting vasospasm, in conjunction with revascularization, can effectively alleviate refractory symptoms.

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