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[Spasm in a single coronary artery].

J L Neimann, A Balaud, N Danchin

    Archives Des Maladies Du Coeur Et Des Vaisseaux
    |June 1, 1985
    PubMed
    Summary

    This study reports a rare case of coronary artery spasm in a patient with a single coronary artery. Calcium antagonists effectively treated the patient's angina, highlighting diagnostic challenges.

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    Area of Science:

    • Cardiology
    • Vascular Medicine
    • Diagnostic Imaging

    Background:

    • A 52-year-old male presented with exertional and resting angina, confirmed by exercise stress testing and myocardial scintigraphy.
    • Initial coronary angiography revealed a rare single coronary artery anomaly originating from the right coronary ostium.

    Observation:

    • The anomalous left coronary artery coursed between the aorta and pulmonary artery.
    • Effort-induced angina was initially attributed to extrinsic compression, but resting angina and failed beta-blocker therapy suggested other mechanisms.
    • An ergometrine test induced significant occlusion in the right coronary artery, consistent with coronary artery spasm and Prinzmetal angina.

    Findings:

    • Coronary artery spasm was diagnosed in a patient with a single coronary artery anomaly.
    • The spasm occurred independently of the anomalous vessel's course.
    • Calcium antagonist drugs provided complete relief from anginal symptoms.

    Implications:

    • This case underscores the diagnostic complexities associated with co-existing coronary artery anomalies and coronary spasm.
    • The potential for misdiagnosis and the importance of provocative testing are highlighted.
    • Prompt recognition and appropriate pharmacotherapy are crucial for managing such rare cardiovascular conditions.

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