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Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
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[Transient subclavian artery spasm observed during percutaneous coronary intervention for acute myocardial

Ozlem Karakurt1, Harun Kiliç, Ramazan Akdemir

  • 1Department of Cardiology, Ankara Dişkapi Training and Research Hospital, Ankara, Turkey. ozlemkarakurt55@yahoo.com

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|March 11, 2010
PubMed

A 68-year-old man with a history of two coronary artery bypass operations was admitted with acute inferior myocardial infarction (AMI) and cardiogenic shock. The electrocardiogram showed ST-segment elevation in leads D2, D3, and aVF. Coronary angiography demonstrated a 75% thrombotic stenosis in the right coronary artery (RCA), 90-99% stenosis in the intermediate coronary artery, and plaques in the circumflex artery. While assessing the patency of bypass grafts, a 99% stenosis was noted in the distal subclavian artery. The culprit artery was deemed to be the RCA, and after direct stenting, TIMI III flow was achieved. Ten days later, stent implantation was performed for the intermediate coronary artery, at which time distal subclavian artery stenosis was not observed. Distal subclavian artery spasm was thought to occur during AMI.

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