Severe lasting coronary spasm detected by multi-detector row computed tomography

Ota, Masato; Anan, Ikuko; Morimoto, Satoshi; Minai, Kosuke; Komukai, Kimiaki; Ogawa, Takayuki; Kikuchi, Makoto; Hongo, Kazuhiro; Yoshimura, Michihiro

doi:10.1016/j.ijcard.2011.02.062

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…However, we recently found two cases that showed severe coronary spasm detected by chance with MDCT examination. 15,16 After these reports, we found similar cases during usual clinical practice, and hypothesized that these cases might not be so rare. We further hypothesized that the coronary artery tonus might be dynamically changed or fluctuate in patients with ischemic heart disease in general, and that these changes may not be limited to patients with coronary spasm definitely diagnosed by the intracoronary acetylcholine infusion test and other methods.…”

Section: Introductionmentioning

confidence: 58%

“…MDCT has recently become a very sensitive modality for detecting the coronary arterial diameter, and it could possibly detect the coronary artery tonus to some extent, although it has been considered that the MDCT examination is not a suitable method for evaluating the coronary tonus. 16 In order to define whether fluctuation of the coronary artery tonus can be detected by MDCT examination, we retrospectively compared the changes in the coronary artery diameter with those in other arterial diameters by serial measurements with MDCT examinations.…”

Section: Introductionmentioning

confidence: 99%

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Fluctuant tonus of the coronary arteries possibly documented by repeated multidetector row computed tomography

Anan¹,

Hongo²,

Kikuchi³

et al. 2014

RRCC

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Objective: Recent advances in multidetector row computed tomography (MDCT) have made it possible to diagnose coronary stenosis with high sensitivity. However, coronary arterial tonus has not been considered when reading MDCT. We hypothesized that MDCT can document fluctuant tonus of the coronary arteries. Methods: The study population consisted of 39 consecutive patients who underwent MDCT twice in our institution with 64-row dual-source MDCT. Measurements were performed with stretched multiplanar reconstruction images using the full width at half maximum method. The coronary arteries were measured at each segment, and the same measurement was performed in the ascending aorta and the left internal thoracic artery (ITA). The percent diameter changes between the first and second measurements were examined in each segment of the coronary arteries and compared with those in the aorta or the ITA. Results: The average percent diameter changes were statistically equivalent between the coronary arteries and the aorta or the ITA. On the other hand, the percent diameter changes in distribution were significantly larger in the coronary arteries than those in the aorta or the ITA. This suggests that the diameter of the coronary arteries is liable to show variation compared to that of other arteries. Conclusion: This study confirmed for the first time that coronary arteries can fluctuate substantially and that these changes can be documented by MDCT. Changes in coronary arterial tonus should therefore be considered when reading MDCT.

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Section: Introductionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Fluctuant tonus of the coronary arteries possibly documented by repeated multidetector row computed tomography

Anan¹,

Hongo²,

Kikuchi³

et al. 2014

RRCC

Self Cite

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“…Although it might be unusual to detect coronary artery spasm by MDCT, there are a few cases with spontaneous coronary artery spasm detected by CT. Hamon and Hamon [6] reported that multislice CT was able to detect asymptomatic coronary artery spasm in a male patient. Ota et al [7] also reported severe coronary artery spasm in a male patient using 64-row MDCT. As compared with these earlier reports, we could observe coronary artery spasm on MDCT imaging with much higher spatial resolution.…”

Section: Discussionmentioning

confidence: 89%

Spontaneous coronary artery spasm accidentally detected by 320-row multi-detector computed tomography

Kawaguchi

Hayashi

Naiki

et al. 2013

Journal of Cardiology Cases

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A 64-year-old woman was introduced to our hospital suspected of having angina pectoris. A 12-lead electrocardiogram showed negative T wave in inferior leads. An echocardiography revealed no abnormality. In 320-row multi-detector computed tomography (MDCT), a severe narrowing of the right coronary artery was detected with collateral vessels between the distal portion of the obstructed right coronary artery and the left anterior descending artery. Coronary angiography showed no stenosis of the right coronary artery and non-obstructive plaques in the left coronary artery. To provoke coronary artery spasm, acetylcholine was infused into the left coronary artery. But, no narrowing was inducible in the left coronary artery. After that, a spasm of the right coronary artery was observed without the injection of acetylcholine into the right coronary artery. The spasm was located in the same site as the narrowing on MDCT imaging. A calcium channel antagonist (benidipine hydrochloride 8 mg/day) and a nitrate (isosorbide dinitrate 80 mg) were effective for coronary artery spasm.

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“…In this case, coronary spasm was detected by CCTA and confirmed by CAG and IVUS. There are currently few reports on cases of coronary spasm detection by CCTA [1] , [2] , [3] , [4] , [5] . Most of these cases used adenosine perfusion or a β-blocker, which often causes coronary spasm as a side effect [4] , [6] .…”

Section: Discussionmentioning

confidence: 99%

Coronary arterial spasm detected by coronary computed tomography angiography and confirmed by intravascular ultrasound

Nakayama

Hirano

Goto

et al. 2018

Radiology Case Reports

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A 40-year-old man was admitted to our hospital for chest pain after smoking. Coronary computed tomography angiography showed severe stenosis in the left anterior descending artery. The stenosis site had no plaque on stretched curved multiplanar reconstruction and short-axis images. Coronary angiography revealed improvement of the severe stenosis after the intracoronary administration of isosorbide dinitrate in the left anterior descending artery. Intravascular ultrasound demonstrated negative remodeling without a plaque and diffuse intima with media thickening at the stenosis site. The chest pain was likely caused by coronary spastic angina, which was treated with diltiazem hydrochloride.

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Severe lasting coronary spasm detected by multi-detector row computed tomography

Cited by 7 publications

References 7 publications

Fluctuant tonus of the coronary arteries possibly documented by repeated multidetector row computed tomography

Fluctuant tonus of the coronary arteries possibly documented by repeated multidetector row computed tomography

Spontaneous coronary artery spasm accidentally detected by 320-row multi-detector computed tomography

Coronary arterial spasm detected by coronary computed tomography angiography and confirmed by intravascular ultrasound

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