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Coronary Vasospasm Abutting the Stent: A Rare Though Important Cause of Recurrent Angina
Bhupinder Singh1, Abhishek Goyal, Bishav Mohan
1Dayanand Medical College and Hospital, Udham Singh Nagar, Ludhiana 560069, India. dr_bhupinders@yahoo.in.
The Journal of Invasive Cardiology
|May 26, 2018
Insights
A right coronary artery angiogram showed subtotal occlusion near a stent, with improved blood flow after nitrate treatment. This led to a diagnosis of vasospastic angina.
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Diagnostic imaging
Background:
- Coronary artery disease management
- Stent placement complications
- Vasospastic angina diagnosis
Observation:
- Angiogram revealed subtotal occlusion in the right coronary artery proximal to a stent.
- Thrombolysis In Myocardial Infarction (TIMI) flow grade I was observed.
- Rapid improvement in flow occurred following intracoronary nitrate administration.
Findings:
- The occlusion was successfully treated with intracoronary nitrates.
- The patient's condition was diagnosed as vasospastic angina.
- The findings highlight the importance of considering vasospasm in stent-related occlusions.
Implications:
- Intracoronary nitrates can be effective in managing acute stent-related occlusions due to vasospasm.
- This case underscores the diagnostic utility of angiography in identifying vasospastic angina.
- Further research may explore optimal management strategies for vasospastic angina presenting as stent occlusion.
Abstract:
Angiogram of the right coronary artery was used to reveal a subtotal occlusion abutting the proximal end of the stent with TIMI I flow that responded quickly to intracoronary nitrates. The patient was diagnosed with vasospastic angina.
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