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Chest pain with ST-T changes on electrocardiogram and localized stenosis on coronary angiography could be a coronary

Bharat Jagiasi1, Prashant Nasa, Debabrata Dash

  • 1Department of Critical Care Medicine, Fortis Raheja Hospital, Mumbai, India.

Journal of Cardiovascular Disease Research
|May 26, 2012
PubMed

Insights

Coronary vasospasm, a cause of chest pain, can be diagnosed with provocative tests. This case highlights a transient stenosis in the left anterior descending artery, managed successfully with medication, avoiding invasive procedures.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Coronary vasospasm is a condition causing chest pain at rest, often with ECG abnormalities and normal coronary angiograms.
  • Provocative testing is typically required for definitive diagnosis but carries significant risks.

Observation:

  • A patient presented with symptoms suggestive of coronary vasospasm.
  • Coronary angiography revealed a localized, transient stenosis in the proximal left anterior descending artery.

Findings:

  • The observed stenosis resolved spontaneously on subsequent angiographic views.
  • The patient's condition improved with medical management alone, and coronary stenting was not required.

Implications:

  • This case suggests that transient coronary artery stenosis can mimic or be associated with vasospasm.
  • Non-invasive or less invasive diagnostic and management strategies may be considered in select cases.
  • Careful interpretation of angiographic findings, especially dynamic changes, is crucial for appropriate patient management.

Keywords:
Coronary vasospasmprinzmetal anginavariant angina

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