Transient ST elevation due to coronary spasm in a young woman

Abstract

A 43-year-old woman was admitted to the coronary care unit at Nordland Hospital (Bodø, Norway) because of a two-week history of transient chest pain. Her total cholesterol level was 8.0 mmol/L and she was a heavy cigarette smoker. On arrival, her vital signs were stable and she was pain-free. An electrocardiogram (ECG) showed inverted and biphasic T waves in the precordial leads ( Figure 1A), but after 30 min, she developed intense pressing chest pain and an ECG indicated severe anterior transmural ischemia ( Figure 1B). She was immediately transferred to the coronary care unit where the pain subsided in 5 min to 10 min. Echocardiography showed normal contractility in all coronary territories. A control ECG showed regression of the ST elevation ( Figure 1C

Wellens syndrome caused by spasm of the proximal left anterior descending coronary artery

“…In addition, our patient's coronary angiography revealed a small plaque in the proximal site of the LAD and slow flow in the LAD (Fig. 3), which was consistent with the conditions contributing to coronary spasm as previously described [5,7]. Moreover, electrocardiogram of our patient on admission showed ST-segment elevation in anterior V2-V6 precordial leads and tall T waves in anterior V2-V4 precordial leads (Fig.…”