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Published on: August 18, 2016

Arteriographic evidence of coronary arterial spasm in acute myocardial infarction

P B Oliva, J C Breckinridge

    Circulation
    |September 1, 1977
    PubMed

    Insights

    Coronary artery spasm was observed in 40% of acute myocardial infarction patients. This spasm, often occurring early after symptom onset, may contribute to heart attacks by interacting with atherosclerosis.

    Area of Science:

    • Cardiology
    • Vascular Medicine
    • Pathophysiology

    Background:

    • Acute myocardial infarction (AMI) is a leading cause of mortality.
    • The role of coronary artery spasm in the early stages of AMI is not fully understood.
    • Atherosclerosis is a known risk factor for AMI.

    Purpose of the Study:

    • To investigate the presence and characteristics of coronary artery spasm in patients with AMI.
    • To explore the potential role of spasm in the pathophysiology of AMI.

    Main Methods:

    • Coronary arteriography was performed before and after intracoronary nitroglycerin administration.
    • Patients were assessed within 12 hours of AMI onset.
    • Coronary artery disease and atherosclerotic obstructions were evaluated.

    Main Results:

    • Coronary arterial spasm was identified in 40% (6 of 15) of AMI patients.
    • Spasm occurred within 6 hours of symptom onset in most cases.
    • Spasm was superimposed on high-grade atherosclerotic lesions.

    Conclusions:

    • Coronary artery spasm may be a significant factor in the early pathophysiology of AMI.
    • A dynamic interaction between spasm, platelet aggregation, and atherosclerotic plaque may precede coronary thrombosis.
    • Catecholamines may contribute to AMI by inducing spasm and/or platelet aggregation.

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