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Diffuse three-vessel coronary artery spasm

Seung Hwan Han, Kwang Kon Koh, Kyu Jin Oh

    International Journal of Cardiology
    |June 9, 2005
    PubMed

    Insights

    A patient experienced early morning chest pain. Coronary artery spasm, specifically affecting three vessels, was diagnosed after an ergonovine provocation test.

    Area of Science:

    • Cardiology
    • Diagnostic Medicine

    Background:

    • Coronary artery spasm can cause chest pain, particularly at rest.
    • Early morning angina may indicate specific cardiac conditions.

    Observation:

    • A 50-year-old woman presented with recurrent early morning chest pain.
    • She completed an exercise stress test (Bruce protocol) for 11 minutes (13 METs) without experiencing chest pain.

    Findings:

    • A provocative ergonovine test identified diffuse, multi-vessel coronary artery spasm.
    • This suggests ergonovine-induced spasm as the cause of her symptoms.

    Implications:

    • Coronary artery spasm should be considered in patients with unexplained chest pain, even with negative exercise tests.
    • Provocative testing is crucial for diagnosing vasospastic angina.
    • Timely diagnosis and management of coronary artery spasm can prevent adverse cardiac events.

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