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[Rest angina caused by coronary spasm].
1Robert-Bosch Krankenhaus, Zentrum für Innere Medizin, Abteilung für Kardiologie und Pulmologie, Stuttgart. anastasios.athanasiadis@rbk.de
Deutsche Medizinische Wochenschrift (1946)
|December 4, 2004
Summary
Coronary artery spasm can cause angina at rest. Prompt diagnosis and medical treatment, including vasodilators and ACE inhibitors, effectively resolved symptoms and prevented further invasive procedures.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Recurrent angina at rest and dyspnea in a 70-year-old woman.
- Initial ECG showed transient negative T-waves; physical exam revealed murmurs.
Observation:
- Exercise ECG showed no ischemia.
- Coronary angiography revealed a non-obstructive plaque in the left circumflex artery.
- Acetylcholine provocation induced coronary artery spasm with chest pain, reversible by nitroglycerin.
Findings:
- Diagnosis of vasospastic angina pectoris confirmed.
- Medical treatment initiated with isosorbide dinitrate, amlodipine, ACE inhibitors, and CSE inhibitors.
Implications:
- Coronary spasm is a significant cause of angina at rest.
- Appropriate medical therapy can effectively manage vasospastic angina.
- Accurate diagnosis prevents unnecessary invasive procedures and guides treatment.