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Coronary arterial wall disruption and intramural hematoma in a patient with coronary spastic angina

Akihiro Terasawa1, Kumiko Ishida, Yosuke Inoue

  • 1Department of Cardiology, Kasugai Municipal Hospital, 1-1-1 Takagi-cho, Kasugai, Aichi, Japan.

International Heart Journal
|March 9, 2012
PubMed

Insights

Coronary artery spasm can lead to acute myocardial infarction through plaque disruption and intramural hemorrhage. This case highlights a rare mechanism involving embolism from a disrupted coronary artery wall.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Pathology

Background:

  • Coronary spastic angina can present with acute myocardial infarction.
  • Plaque rupture, thrombosis, and reduced coronary flow are known mechanisms.

Observation:

  • A 45-year-old woman with coronary spastic angina developed acute myocardial infarction.
  • Thrombectomy revealed a disrupted coronary artery wall with intramural hemorrhage.

Findings:

  • The acute myocardial infarction was attributed to embolism from the disrupted coronary artery wall.
  • Spasm-induced disruption and hemorrhage were key pathological findings.

Implications:

  • This case expands understanding of acute myocardial infarction mechanisms in coronary spastic angina.
  • Highlights the potential for intramural hemorrhage and embolism as a cause.

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