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Postmyocardial infarction angina and coronary spasm

T J Moran, W J French, H F Abrams

    The American Journal of Cardiology
    |July 1, 1982
    PubMed

    Insights

    Coronary artery spasm, a cause of chest pain and myocardial infarction, can also trigger angina early after a heart attack. This study demonstrates coronary vasospasm as a cause of postinfarction angina in three patients.

    Area of Science:

    • Cardiology
    • Vascular Medicine

    Background:

    • Chest pain following myocardial infarction (MI) can have various causes.
    • Coronary artery spasm is a recognized cause of chest pain and MI, but its role in the early postinfarction period is less understood.

    Observation:

    • Three patients presented with chest pain within 1 day to 3 weeks after MI.
    • Coronary artery spasm was diagnosed in all three patients using ergonovine maleate provocation.
    • Spasm occurred in the infarct-related artery in two patients and a remote vessel in one.

    Findings:

    • Ergonovine maleate testing confirmed coronary vasospasm as the cause of chest pain in these post-MI patients.
    • Two patients required intracoronary nitroglycerin to restore blood flow in the affected coronary artery.
    • The findings highlight coronary vasospasm as a potential cause of angina in the early post-MI phase.

    Implications:

    • Clinicians should consider coronary vasospasm in the differential diagnosis of chest pain occurring early after myocardial infarction.
    • Early identification and treatment of coronary vasospasm may prevent recurrent ischemia and improve outcomes in post-MI patients.
    • Further research is warranted to elucidate the mechanisms and prevalence of coronary vasospasm in the post-MI setting.

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