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Left coronary artery spasm causing severe left ventricular dysfunction without myocardial infarction
R J Freedman1, F Fuentes, R W Smalling
1Hermann Hospital and the University of Texas Health Science Center at Houston Medical School, Houston, Texas 77030, USA.
Texas Heart Institute Journal
|June 1, 1986
Summary
Coronary artery spasm can cause severe heart dysfunction, mimicking heart attack. Emergency bypass surgery successfully restored heart function, showing spasm can precede myocardial infarction and aggressive treatment is vital.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Coronary artery spasm can lead to significant left ventricular dysfunction.
- The clinical presentation may resemble acute myocardial infarction with ECG changes.
Purpose of the Study:
- To describe a case of recurrent left anterior descending coronary artery spasm.
- To investigate the impact of surgical intervention on coronary spasm-induced cardiac dysfunction.
Main Methods:
- Case report of a patient with persistent coronary artery spasm.
- Emergency coronary artery bypass surgery.
- Post-operative assessment of left ventricular function and myocardial infarction markers.
Main Results:
- The patient experienced recurrent left anterior descending coronary artery spasm causing severe left ventricular dysfunction.
- Emergency bypass surgery resulted in complete reversal of left ventricular dysfunction.
- No evidence of acute myocardial infarction or elevated CPK enzymes post-surgery.
Conclusions:
- Coronary artery spasm can precede the development of acute myocardial infarction.
- Massive left ventricular dysfunction can occur in this intermediate coronary syndrome.
- Aggressive surgical intervention, such as emergency bypass surgery, can restore normal left ventricular function.