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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

191
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

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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...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

55
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
55
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

98
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...
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Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

68
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...
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Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

88
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
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Updated: Oct 29, 2025

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
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Widespread ST-segment elevation due to diffuse coronary artery spasm: A case report.

Lin Bai1, Fei Chen1, Yong Peng1

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|July 12, 2021
PubMed
Summary

Coronary artery spasm (CAS) can cause widespread ST-segment elevation and elevated cardiac troponin T, mimicking a heart attack. This case highlights diffuse CAS as a cause of severe acute coronary syndrome (ACS).

Keywords:
ST-segment elevationcardiogenic syncopecoronary artery spasmvasospastic angina

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Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Clinical Case Reports

Background:

  • Coronary artery spasm (CAS) is an important, though uncommon, cause of acute coronary syndrome (ACS).
  • Distinguishing CAS from obstructive coronary artery disease is crucial for appropriate management.

Observation:

  • A 42-year-old woman presented with prolonged chest pain, widespread ST-segment elevation on ECG, and elevated cardiac troponin T.
  • Initial coronary angiography revealed diffuse CAS, with significant morphological changes compared to a later study.

Findings:

  • The patient's symptoms and ECG changes were attributed to diffuse coronary artery spasm, not fixed stenosis.
  • This presentation underscores the potential of diffuse CAS to manifest as severe ACS with widespread ECG abnormalities.

Implications:

  • Diffuse CAS should be considered in the differential diagnosis of ACS, especially in the absence of obstructive coronary lesions.
  • Accurate diagnosis of CAS is vital for guiding treatment and preventing recurrent ischemic events.