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Vasospasm-induced ST-segment elevation myocardial infarction in a premenopausal woman with endothelial dysfunction

Bonpei Takase1, Yukie Kobayashi2, Natsuko Sasaki2

  • 1Department of Intensive Care Medicine, National Defense Medical College, Tokorozawa city, Saitama, Japan.

Oxford Medical Case Reports
|April 25, 2022
PubMed

Insights

Coronary artery vasospasm causes ST-elevation myocardial infarction (STEMI) due to endothelial dysfunction. Endothelial function tests like FMD and EndPAT may predict outcomes in women with VSA-induced STEMI.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Medicine

Background:

  • ST-segment elevation myocardial infarction (STEMI) can arise from coronary artery vasospasm (VSA), linked to endothelial dysfunction.
  • The diagnostic utility of endothelial function tests in VSA-induced STEMI remains unclear.

Observation:

  • A case study of a 43-year-old woman with atypical chest pain and no traditional risk factors was presented.
  • STEMI attributed to VSA was diagnosed in this patient.
  • Flow-mediated vasodilatation (FMD) measured 3.8%, and the reactive hyperaemia index (EndPAT) was 1.23.

Findings:

  • Endothelial dysfunction is identified as the likely cause of STEMI in this case.
  • The patient's low FMD and reactive hyperaemia index suggest significant endothelial impairment.

Implications:

  • Endothelial function tests, specifically FMD and EndPAT, may serve as valuable tools for prognostication.
  • These tests could help predict adverse outcomes in young, premenopausal women experiencing VSA-induced STEMI.

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