Related Experiment Video

Updated: Feb 21, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

16.9K

Spontaneous Left Main and Right Coronary Artery Spasm in a Patient With Vasospastic Angina

Analkumar Parikh1, Thomas Paul Vacek1

  • 1Wright State University, Dayton, OH, USA.

Journal of Investigative Medicine High Impact Case Reports
|October 10, 2017
PubMed

Insights

Coronary artery spasm, a rare cause of chest pain, can mimic heart attacks. This case highlights how nitroglycerin and calcium channel blockers effectively treated significant coronary obstructions caused by spasm.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Clinical Case Reports

Background:

  • Coronary artery spasm is a rare condition that can present as myocardial infarction.
  • It typically affects a single coronary vessel during an event.
  • Patients often have risk factors like hypertension, hyperlipidemia, and tobacco abuse.

Purpose of the Study:

  • To describe a case of coronary artery spasm mimicking myocardial infarction.
  • To illustrate the diagnostic and therapeutic approach in such cases.
  • To emphasize the importance of considering coronary spasm in patients with unexplained chest pain.

Main Methods:

  • A 43-year-old male with risk factors presented with chest pain.
  • Diagnostic workup included a positive stress study indicating ischemia.
  • Coronary angiography revealed significant left main and right coronary artery obstruction.

Main Results:

  • Coronary angiography showed severe stenoses in the left main and proximal right coronary arteries.
  • Intracoronary nitroglycerin administration resolved the stenoses, improving flow to TIMI III.
  • The patient responded well to dihydropyridine calcium channel blockers and smoking cessation.

Conclusions:

  • Coronary artery spasm can cause severe, reversible coronary obstructions.
  • Prompt diagnosis and medical management, including vasodilators and lifestyle changes, are crucial.
  • This case underscores the importance of considering coronary spasm in the differential diagnosis of acute coronary syndromes.

Keywords:
anginacalcium channel blockercardiologycoronary spasminterventionalnitroglycerin

More Related Videos

Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm06:18

Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm

Published on: September 17, 2021

1.9K
Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

Published on: February 3, 2021

4.3K

Related Concept Videos

Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
287
Angina I: Introduction01:30

Angina I: Introduction

Definition and Symptoms: Angina (angina pectoris) is chest pain or discomfort caused by myocardial ischemia, which occurs when the heart muscle receives insufficient oxygen-rich blood. It typically manifests as pressing, squeezing, or crushing sensations in the chest and may radiate to the shoulders, arms, neck, jaw, or back.Primary Cause: In a healthy state, the coronary arteries can dilate (widen) to increase blood flow and meet the increased oxygen demand during physical activity or...
585
Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
464
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
449
Vascular Spasm01:16

Vascular Spasm

The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
4.2K
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
489