Reversible right bundle branch block caused by spasm of the anterior septal branch: case report
Yue Bao1, Hongwei Yi2, Jun Ma3
1Departmentof Cardiology, Wuhan Asia Heart Hospital, Wuhan, China.
Insights
Coronary artery spasm (CAS) in the anterior septal branch is rare but can cause acute myocardial infarction. Prompt diagnosis via coronary angiography and anti-spasm treatment are crucial for favorable outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Myocardial Infarction
Background:
- Coronary artery spasm (CAS) typically affects epicardial arteries.
- Spasms of the anterior septal branch within the myocardium are rare and poorly documented.
- This rarity can lead to diagnostic challenges and potential misdiagnosis.
Background:
Coronary Artery Spasm (CAS) often presents in the epicardial coronary arteries. The anterior septal branch is distributed within the myocardium, and occurrences of spasms are rare. Currently, there is no available literature on this topic, and the onset of symptoms remains elusive, potentially leading to misdiagnosis.
Case Presentation:
We present a case of acute myocardial infarction (AMI) caused by spasm in the anterior septal branch, accompanied by transient right bundle branch block (RBBB). The administration of nitroglycerin via intracoronary injection resulted in the alleviation of spasm in the anterior septal branch and the disappearance of RBBB. After the administration of anti-coronary spasm medications, the patient exhibited favorable recovery outcomes. No episodes of myocardial ischemia were observed during the six-month follow-up.
Conclusions:
The presence of new RBBB in patients may warrant consideration of anterior septal coronary artery spasm, which necessitates urgent coronary angiography to clarify the underlying cause and facilitate the prompt initiation of anti-spasm treatment.
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