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Acute Heart Failure Triggered by Coronary Spasm With Transient Left Ventricular Dysfunction.

Yusuke Adachi¹, Kenichi Sakakura, Tatsuro Ibe

¹Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University.

International Heart Journal

|April 4, 2017

Summary

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Coronary spasm, an abnormal artery contraction, can cause acute heart failure. The acetylcholine provocation test aids in diagnosing this condition and elevated ventricular filling pressure.

Area of Science:

Cardiology
Internal Medicine

Background:

Coronary spasm involves abnormal contraction of epicardial coronary arteries, leading to myocardial ischemia.
This condition impairs myocardial contractility and relaxation, resulting in elevated ventricular filling pressure.

Observation:

A 55-year-old woman experienced recurrent acute heart failure attributed to coronary spasm.
The patient presented with symptoms suggestive of heart failure, prompting further investigation.

Findings:

Acetylcholine provocation testing combined with right heart catheterization effectively diagnosed both coronary artery spasm and elevated ventricular filling pressure.
Diagnostic confirmation was achieved through invasive hemodynamic monitoring and provocative testing.

Implications:

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Coronary spasm should be considered in the differential diagnosis for patients with repeated episodes of acute heart failure.
Early recognition and diagnosis of coronary spasm can improve patient outcomes and guide appropriate management strategies.