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Blocked Coronary Artery Due To Coronary Spasm Treated With Stent Insertion: A Sub-Optimal Result?

Habib Rehman Khan1, Sajid Aslam1

  • 1Cardiology Department, Nottingham University Hospitals, Manchester Royal Infirmary, Manchester, UK.

Journal of Ayub Medical College, Abbottabad : JAMC
|July 17, 2017
PubMed

Insights

Coronary artery spasm can mimic heart attack (myocardial infarction) and cause artery occlusion. This case highlights successful treatment of severe coronary spasm with stenting and medication, preventing long-term damage.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Myocardial infarction (MI) is a leading cause of chest pain, presenting as STEMI or NSTEMI.
  • Coronary artery spasm, particularly with underlying atheroma, can cause significant coronary artery occlusion.
  • Spasm is often misdiagnosed as acute thrombotic coronary occlusion.

Observation:

  • A 42-year-old male with cardiac risk factors presented with acute chest pain.
  • Coronary angiography revealed right epicardial coronary artery occlusion due to severe spasm at an atheroma site.
  • The intense spasm deformed the initial coronary stent, necessitating a second stent placement.

Findings:

  • Successful management of severe coronary artery spasm causing artery occlusion.
  • Dual stenting was required due to spasm-induced stent deformation.
  • Secondary prevention with diltiazem and nitrates effectively managed coronary spasm.

Implications:

  • Highlights the importance of differentiating coronary spasm from thrombotic events in acute chest pain.
  • Demonstrates the efficacy of interventional and pharmacological approaches in managing severe coronary spasm.
  • Suggests that prompt and appropriate treatment can lead to excellent long-term outcomes in patients with coronary spasm.

Keywords:
Coronary angiogramCoronary spasmMyocardial infarctionStent

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