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Case Reports
. 2018 Apr;72(2):154-156.
doi: 10.5455/medarh.2018.72.154-156.

Acute Coronary Syndrome With Normal Coronary Arteries: a Case of Spontaneous Spasm Lysis

Vogiatzis Ioannis  1 , Koutsambasopoulos Konstantinos  1 , Samaras Antonios  1 , Bostanitis Ioannis  1
Affiliations
Case Reports

Acute Coronary Syndrome With Normal Coronary Arteries: a Case of Spontaneous Spasm Lysis

Vogiatzis Ioannis et al. Med Arch. 2018 Apr.

Abstract

Introduction: Patients suffering from Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) are found with no obstructive coronary artery disease on coronary arteriography. The Aim of this interesting case report is to present a patient with acute chest pain, temporal ST-segment elevation and MINOCA.

Case report: A case of a young woman who presented with acute chest pain suggestive of angina, with temporal ST-segment elevation, accidentally recorded and not rising of myocardial necrosis biomarkers in blood tests is described. A coronary angiography via right radial artery was performed and revealed normal coronary arteries. She was defined suffering from Myocardial infarction with Non-Obstructive Coronary Arteries (MINOCA) which occurs in 1-14% of Myocardial Infarction cases. Treatment with nitrates calcium, calcium channel blockers and antiplatelet in the basis of ACS is highly indicated.

Conclusion: Coronary artery spasm is not a rare cause of ACS. Coronary angiography is indicated in all cases to exclude severe coronary heart disease.

Keywords: MINOCA; acute coronary syndrome; coronary artery spasm; unstable angina.

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Figures

Figure 1.
Figure 1.. ECG performed during chest pain episode showing a ST-segment elevation in precordial leads V1-V5 (Red arrow) which was spontaneously resolved (Black arrow), accompanied by pain relief.
Figure 2.
Figure 2.. Next day ECG developed negative T waves in precordial leads V1-V5.
Figure 3.
Figure 3.. Coronary angiography showing normal coronary arteries. A: Left Coranary Artery (LCA), B: Right Coronary Artery (RCA).
See this image and copyright information in PMC

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