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Arteriographic demonstration of coronary artery spasm during thrombolysis

A H Karim1, W Bennett, S J Silver

  • 1Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas, USA.

Texas Heart Institute Journal
|January 1, 1988
PubMed

Insights

Coronary artery spasm was documented during thrombolysis for myocardial infarction. This finding supports spasm as a potential trigger for coronary thrombosis, offering new insights into heart attack mechanisms.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Acute myocardial infarction often involves coronary artery occlusion.
  • The role of coronary artery spasm in thrombosis is not fully understood.

Purpose of the Study:

  • To document the occurrence of coronary artery spasm during thrombolytic therapy for acute myocardial infarction.
  • To investigate the potential link between coronary spasm and the initiation of coronary thrombosis.

Main Methods:

  • Case report of a 60-year-old male with inferior-wall myocardial infarction.
  • Arteriography to visualize coronary artery occlusion and spasm.
  • Treatment with intravenous tissue plasminogen activator and intracoronary nitroglycerin.

Main Results:

  • Successful reopening of the occluded right coronary artery.
  • Arteriographic documentation of coronary artery spasm during clot lysis.
  • Complete resolution of spasm with intracoronary nitroglycerin.
  • Follow-up arteriography revealed a normal right coronary artery.

Conclusions:

  • Coronary artery spasm can occur during thrombolytic therapy for myocardial infarction.
  • This case provides direct evidence supporting the hypothesis that coronary spasm may initiate coronary thrombosis.
  • Further research is warranted to explore the interplay between spasm and thrombosis in acute coronary syndromes.

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