[Acute coronary syndromes with ST elevation and angiographically normal culprit coronary arteries: Case report and
X Halna du Fretay1, O Dibon2, J Naël2
1Service de cardiologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Service de cardiologie, centre hospitalier universitaire Bichat - Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Service de cardiologie, centre hospitalier régional d'Orléans, 14, avenue de l'Hôpital, 45067 Orléans, France.
Insights
Acute coronary syndrome often stems from plaque rupture, but non-atherosclerotic causes like Tako-tsubo cardiomyopathy and vasospastic angina require distinct management strategies. Understanding these alternative pathways is crucial for effective treatment.
Area of Science:
- Cardiology
- Pathophysiology
- Medical Case Studies
Background:
- Acute coronary syndrome (ACS) is predominantly caused by atherosclerotic plaque rupture.
- However, a subset of ACS cases involves different pathophysiological mechanisms.
- These alternative mechanisms necessitate tailored subsequent treatment strategies despite similar initial management.
Abstract:
Acute coronary syndrome results in most cases of atherosclerotic plaque rupture. In a few cases, the physiopathological mechanism is different. This does not necessarily change the initial strategy but the subsequent treatments. We report three cases of clinical presentations of acute coronary syndrome whose pathophysiological mechanism is not or not mainly due to atherosclerotic lesions. Based on these cases and a review of the literature, two topics will be tackled: the diagnostic and therapeutic strategy in the management of Tako-tsubo cardiomyopathies and also acute coronary syndromes due to vasospastic angina.
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