Multivessel Coronary Artery Spasm

Richardson, J. David; Nelson, Adam; Worthley, Stephen G.; Teo, K.; Baillie, T.; Worthley, M.

doi:10.1016/j.hlc.2011.07.007

Cited by 2 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ECG changes seen in our patient are similar to those of patients with proven multivessel coronary vasospasm. (12,13) In a study of patients with suspected vasospastic angina, diffuse multivessel involvement was described to be present in the majority of patients who demonstrated coronary vasospasm. (14) The involvement of the entire pericardial sac, as evident in this patient, increases the likelihood of multivessel coronary inflammation and, by extension, multivessel vasospasm.…”

Section: U Lt I V E S S E L C O R O N a R Y A R T E R Y S Pa S M I mentioning

confidence: 99%

Multivessel coronary artery spasm in pericarditis

Lim

Singh

Loh

et al. 2018

smedj

View full text Add to dashboard Cite

Dear Sir, Coronary vasospasm can result in tombstone-like ST elevations in the presence of non-obstructive coronary arteries on angiography. Coronary vasospasm has been reported to coexist with myocarditis, possibly due to endothelial dysfunction or coronary smooth muscle cell hyperreactivity. We herein describe a novel presentation of tombstone-like ST elevations that were likely from multivessel coronary vasospasm in a patient with pericarditis. A 40-year-old man with a three-day history of an infected right lower molar tooth presented to the emergency department with dysphagia, shortness of breath and right neck swelling. There was no complaint of chest pain, and he had no past medical history or any cardiac problems prior to presentation. Electrocardiography (ECG) performed at the point of admission showed typical global concave upward ST elevations with PR interval depression consistent with pericarditis (Fig. 1a). Further investigations revealed elevated inflammatory markers. Computed tomography of the neck and thorax, which was performed in view of his presentation history, showed gas gangrene in the neck communicating with the mediastinum, likely due to contiguous infection. The patient underwent surgery for his disease and received broad-spectrum antibiotics, as guided by microbiological cultures. On the sixth day of admission, diffuse tombstone-like non-territorial ST elevations were seen on ECG without any symptom or haemodynamic instability (Fig. 1b); they completely resolved after 15 minutes. There were no Q waves thereafter. The diffuse tombstone-like ST elevations recurred on the tenth day of admission and again resolved after 15 minutes. Peak serum troponin levels were marginally elevated at 0.063 mcg/L (normal < 0.040 mcg/L). The patient was under sedation and intubated for the first two weeks of his admission.

show abstract

Section: U Lt I V E S S E L C O R O N a R Y A R T E R Y S Pa S M I mentioning

confidence: 99%

Multivessel coronary artery spasm in pericarditis

Lim

Singh

Loh

et al. 2018

smedj

View full text Add to dashboard Cite

show abstract

Malignant Multivessel Coronary Spasm Complicated by Myocardial Infarction, Transient Complete Heart Block, Ventricular Fibrillation, Cardiogenic Shock and Ischemic Stroke

2014

View full text Add to dashboard Cite

Multivessel coronary spasm resulting to cardiogenic shock and malignant ventricular arrhythmias though rare has been reported in the literature. The disease seems to be more prevalent in Asians. There have been isolated reports of coronary spasm in patients with reactive airway disease. We report the first case of spontaneous multivessel spasm in a male patient with bronchial asthma of Arab ethnicity resulting in acute myocardial infarction complicated by cardiogenic shock, recurrent ventricular arrhythmias, and transient complete heart block. Literature review of similar cases suggests a strong association with bronchial asthma and a more malignant course in patients with reactive airway disease. The role of intracoronary nitroglycerin in proving the diagnosis even in patients in shock on maximal inotropic supports and intra-aortic balloon pump is highlighted and the importance of considering multivessel coronary spasm as a cause for acute coronary syndrome even in patients with conventional risk factors for atherosclerotic coronary artery disease is reinforced in the discussion of this case.

show abstract

Multivessel Coronary Artery Spasm

Cited by 2 publications

References 8 publications

Multivessel coronary artery spasm in pericarditis

Multivessel coronary artery spasm in pericarditis

Malignant Multivessel Coronary Spasm Complicated by Myocardial Infarction, Transient Complete Heart Block, Ventricular Fibrillation, Cardiogenic Shock and Ischemic Stroke

Contact Info

Product

Resources

About