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Coronary Artery Spasm in Multivessel ACS: What More Should We Know?

Abhishek Jaiswal1, Gregory Gustafson1, Emmanuel N Moustakakis1

  • 1Division of Cardiology, Department of Internal Medicine, New York Hospital Queens/Weill Medical College of Cornell University, New York, New York.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|January 18, 2014
PubMed

Insights

Coronary spasm can mimic acute coronary syndrome (ACS), complicating diagnosis and treatment. Identifying spasm with vasodilators can prevent unnecessary stenting and improve patient outcomes.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Acute coronary syndrome (ACS) encompasses ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable angina.
  • The prevalence and impact of coronary artery spasm in ACS patients are not well-defined.
  • Concomitant coronary spasm can obscure underlying atherosclerotic disease, leading to diagnostic and therapeutic challenges.

Observation:

  • This case report details the management of an ACS patient with both coronary spasm and atherosclerotic disease.
  • The patient presented with symptoms suggestive of ACS, requiring careful diagnostic evaluation.

Findings:

  • Routine vasodilator administration in ACS cases can help identify underlying coronary spasm.
  • Prompt identification of coronary spasm can prevent inappropriate stenting procedures.

Implications:

  • Recognizing and treating coronary spasm in ACS is crucial for accurate diagnosis and effective management.
  • Preventing inappropriate stenting in spasm cases can significantly improve clinical outcomes for ACS patients.
  • This highlights the importance of considering coronary spasm in the differential diagnosis of ACS.

Keywords:
STEMIacute coronary syndromecoronary interventioncoronary spasmvasodilator

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