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Coronary Vasospasm Presenting as ST-Elevation Myocardial Infarction

Arminder Singh1, Lam Nguyen2, Stephanie Everest2

  • 1Internal Medicine, Cape Fear Valley Medical Center, Fayetteville, USA.

Cureus
|March 21, 2022
PubMed

Insights

Vasospastic angina (VSA), or Prinzmetal angina, involves reversible coronary artery vasoconstriction. This case highlights the diagnostic challenge of VSA mimicking acute coronary syndrome, particularly ST-elevation myocardial infarction.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Vasospastic angina (VSA), also known as Prinzmetal angina, is characterized by reversible coronary artery vasoconstriction.
  • It is a frequent diagnosis in patients with ischemic symptoms but without obstructive coronary artery disease.

Observation:

  • Patients with VSA can exhibit symptoms similar to acute coronary syndrome (ACS), including chest pain, dyspnea, and syncope.
  • Diagnosing VSA is challenging due to its clinical presentation mirroring active ACS.

Findings:

  • This report details a case of a 69-year-old female presenting with ST-elevation myocardial infarction (STEMI).
  • The patient was ultimately diagnosed with and treated for vasospastic angina, illustrating a diagnostic dilemma.

Implications:

  • Accurate diagnosis of VSA is crucial for appropriate treatment and patient management.
  • Recognizing VSA's potential to mimic ACS can improve diagnostic accuracy and prevent unnecessary interventions.

Keywords:
coronary artery spasmecgst-elevation myocardial infarction (stemi)stressvasospastic angina

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