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Case Reports
. 2017 Jan;11(1):OD08-OD09.
doi: 10.7860/JCDR/2017/24342.9301. Epub 2017 Jan 1.

Prinzmetals Angina Masquerading as Acute Pericarditis

Ashwal Adamane Jayaram  1 , Mugula Sudhakar Rao  2 , R Padmakumar  3 , Uk Abdul Razak  1
Affiliations
Case Reports

Prinzmetals Angina Masquerading as Acute Pericarditis

Ashwal Adamane Jayaram et al. J Clin Diagn Res. 2017 Jan.

Abstract

Coronary artery spasm is an intense vasoconstriction of the coronary arteries and may be responsible for the myocardial ischemia, myocardial infarction as well as sudden deaths. Coronary angiography is generally needed to identify the cause. Coronary artery spasm is a multifactorial disease with underlying mechanism still poorly understood. Here, we present case of a 48-year-old male with no significant past history who presented with acute episodic onset chest pain. Clinical, Electrocardiography (ECG) and echocardiographic findings suggested pericarditis but a diagnostic coronary angiography revealed significant coronary vasospasm. Patient's symptoms significantly improved with calcium channel blockers and Nitroglycerine (NTG).

Keywords: Coronary vasospasm; Nitroglycerine; Recurrent angina.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Admission ECG demonstrated ST-segment elevation in all the anterior and also inferior leads with ST segment depression in aVR lead and presence of PR segment depression on leads I,II, aVF, V1.
[Table/Fig-2]:
[Table/Fig-2]:
Repeat ECG after 10 hours showed resolution of ST changes in anterior chest leads with some residual ST elevations on leads V4-V6.
[Table/Fig-3]:
[Table/Fig-3]:
On angiography in PA cranial view showing LAD artery which is a type 3 vessel with an arrow depicting long segment more than 40 mm, tubular 80-85% stenosis in mid part.
[Table/Fig-4]:
[Table/Fig-4]:
On angiography in PA cranial view showing LAD artery after 200 micrograms of nitroglycerin with arrow depicting relief of vasospasm.
See this image and copyright information in PMC

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