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A Case of Refractory Variant Angina
Yasuhiro Nagayoshi1, Miwa Dekita1, Masato Nishi1
1Department of Cardiology, Amakusa Medical Center, Amakusa, JPN.
Cureus
|April 17, 2024
Summary
Variant angina, a severe form of coronary vasospasm, can be challenging to diagnose. This case highlights the limitations of spasm provocation testing, even in refractory cases, emphasizing the need for clinical awareness.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Coronary vasospasm involves abnormal contraction of coronary arteries.
- Variant angina is a severe form characterized by transmural ischemia and ECG changes.
Observation:
- A 61-year-old woman presented with refractory variant angina.
- Initial pharmacologic spasm provocation testing did not yield a definitive diagnosis.
Findings:
- The patient experienced recurrent acute coronary syndrome attributed to coronary vasospasm.
- Pharmacologic spasm provocation tests have high reported sensitivity and specificity in variant angina.
Implications:
- Physicians must recognize the limitations of spasm provocation tests.
- Clinical vigilance is crucial for diagnosing coronary vasospasm, especially in refractory cases.
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