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Sudden diffuse spasm of multiple coronary arteries: A case report.
Hui Cai1, Shuxia Chen2, Dongxiao Wang2
1Department of Cardiology, Hebei General Hospital, Hebei North University, Shijiazhuang, Hebei Province, China.
Medicine
|January 12, 2024
Summary
This case report details a rare instance of diffuse multivessel coronary artery spasm (DMV-CAS) triggered by Valsalva action, leading to subtotal coronary artery occlusion. Prompt diagnosis and treatment led to symptom resolution and no recurrence during follow-up.
Area of Science:
- Cardiology
- Clinical Case Reports
- Vascular Medicine
Background:
- Diffuse multivessel coronary artery spasm (DMV-CAS) is a rare condition characterized by severe, reversible spasm in over two major coronary arteries.
- Its extensive lesion scope can lead to complications, and brief, transient episodes make clinical diagnosis challenging.
Observation:
- A 68-year-old male presented with sudden chest pain following forced defecation.
- Electrocardiogram revealed transient ST elevation and T wave abnormalities.
- Emergency coronary angiography (CAG) showed diffuse stenosis in three major coronary arteries, consistent with DMV-CAS.
Findings:
- Diagnosis of DMV-CAS was confirmed by CAG findings and response to nitroglycerin.
- The patient received anti-vasospasm, antiplatelet, and lipid-regulating medications.
- Symptoms resolved completely, and ECG normalized upon discharge.
Implications:
- This case underscores the importance of recognizing DMV-CAS, even when triggered by Valsalva maneuvers.
- Prompt identification and management are crucial for preventing acute myocardial infarction.
- Clinicians should be vigilant about potential triggers of coronary artery spasm.
