Unusual Recurrent Multivessel Coronary Artery Spasm: A Case Report and Literature Review

Ann Noninvasive Electrocardiol. 2024 Nov;29(6):e70019. doi: 10.1111/anec.70019.

Abstract

Coronary artery spasms (CAS) can manifest in various forms, from silent ischemia to severe cardiac events like myocardial infarction and sudden death. This case involves a 56-year-old male with recurrent ischemic chest pain and varying ECG signs. Cardiac catheterization revealed multiple coronary spasms that resolved spontaneously or with intracoronary nitroglycerin. The report emphasizes the severe presentations of multiple CAS and the importance of thorough diagnostic evaluation to avoid unnecessary interventions, highlighting the diagnostic challenges in managing such cases.

Keywords: cardiac anatomy; cardiac fibrillation/defibrillation; electrophysiology‐cardiac arrest/sudden death; non‐invasive techniques – signal‐averaged ECG; pharmacology – pharmacokinetics/dynamics.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cardiac Catheterization / methods
  • Chest Pain / diagnosis
  • Chest Pain / etiology
  • Coronary Angiography* / methods
  • Coronary Vasospasm* / complications
  • Coronary Vasospasm* / diagnosis
  • Coronary Vasospasm* / diagnostic imaging
  • Coronary Vasospasm* / physiopathology
  • Electrocardiography* / methods
  • Humans
  • Male
  • Middle Aged
  • Nitroglycerin / therapeutic use
  • Recurrence*
  • Vasodilator Agents / therapeutic use

Substances

  • Nitroglycerin
  • Vasodilator Agents