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Multiple Life-threatening Coronary Artery Spasms after Percutaneous Coronary Intervention for Acute Coronary Syndrome

Toshiki Sawai1,2, Yu Tajima1, Atsuya Hirota1

  • 1Department of Cardiology, Mie Prefectural General Medical Center, Japan.

Internal Medicine (Tokyo, Japan)
|August 28, 2018
PubMed

Insights

Beta-blockers may not be suitable for all acute coronary syndrome patients. Careful consideration is needed for Japanese patients prone to coronary artery spasm, especially those with normal heart function.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Acute coronary syndrome (ACS) management often includes beta-blockers post-percutaneous coronary intervention.
  • Preserved left ventricular systolic function is a common characteristic in some ACS patient cohorts.

Observation:

  • A 69-year-old male patient experienced recurrent chest pain and hemodynamic instability in the subacute phase after ACS treatment.
  • Coronary angiography revealed multiple instances of coronary artery spasm as the cause of symptoms.

Findings:

  • Discontinuation of beta-blocker therapy and initiation of calcium antagonists successfully resolved angina episodes.
  • Coronary artery spasm is a notable concern in Japanese patient populations.

Implications:

  • Routine beta-blocker administration post-ACS warrants careful evaluation in Japanese patients susceptible to coronary artery spasm.
  • Treatment strategies should be individualized, considering patient ethnicity and specific cardiac conditions like coronary artery spasm.

Keywords:
acute coronary syndromebeta-blockercalcium channel blockerlife-threateningmultiple coronary artery spasm

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