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Spontaneous and simultaneous multivessel coronary spasm causing multisite myocardial infarction, cardiogenic shock,

Yao-Tsung Chuang1, Kwo-Chang Ueng

  • 1Cardiovascular Study Group, Institute of Medicine, Division of Cardiology, Chung Shan Medical University Hospital, Taichung, Taiwan.

Circulation Journal : Official Journal of the Japanese Circulation Society
|January 31, 2009
PubMed

Insights

A rare case of simultaneous anterior and inferior myocardial infarction occurred in a 57-year-old man. Prompt treatment with isosorbide dinitrate successfully relieved coronary artery occlusion.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Variant angina is a condition characterized by chest pain due to coronary artery spasms.
  • Myocardial infarction (MI) typically results from prolonged blockage of coronary arteries.

Observation:

  • A 57-year-old man with a history of variant angina presented with simultaneous anterior and inferior myocardial infarction.
  • The patient also experienced atrioventricular block, cardiogenic shock, and ventricular fibrillation.

Findings:

  • Left coronary angiography revealed concurrent occlusion of the left anterior descending and left circumflex arteries.
  • Intracoronary isosorbide dinitrate administration successfully relieved these occlusions.

Implications:

  • This case highlights a rare presentation of myocardial infarction potentially linked to variant angina.
  • It underscores the importance of considering vasospasm in complex MI cases and the efficacy of vasodilators.

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