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[Moderate coronary lesion with severe vasospasm and the development of collateral circulation in a patient with

Petra Sanz-Mayordomo1, Manuel Alonso-Gutiérrez, Raquel Campuzano

  • 1Unidad de Hemodinámica, Fundación Hospital Alcorcón, Madrid, Spain. psanz@fhalcorcon.es

Revista Espanola De Cardiologia
|August 2, 2005
PubMed

Insights

Coronary collateral circulation can develop with moderate coronary lesions due to vasospasm, mimicking severe blockages. This case highlights how vasospastic angina can present similarly to significant coronary artery disease.

Area of Science:

  • Cardiology
  • Vascular Biology

Background:

  • Coronary collateral circulation typically forms in response to severe coronary artery stenosis and recurrent ischemia.
  • Vasospastic angina can present with symptoms mimicking severe coronary lesions.

Observation:

  • A patient presented with effort angina and ST-segment depression during treadmill testing.
  • Coronary angiography revealed severe right coronary artery stenosis and significant collateral circulation.

Findings:

  • Intracoronary nitroglycerin administration revealed the stenosis was moderate, not severe.
  • The observed coronary collateral circulation resolved after nitroglycerin treatment, indicating a vasospastic origin.

Implications:

  • This case demonstrates that vasospastic angina can induce significant coronary collateralization, mimicking severe obstructive coronary artery disease.
  • Accurate diagnosis requires considering vasospasm as a cause for collateral development, especially when stenosis appears moderate after treatment.

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