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KMID : 1036020180070010068
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지질.동맥경화학회지
2018 Volume.7 No. 1 p.68 ~ p.75
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Successful Treatment of Coronary Spasm with Atherosclerosis Rapidly Progressing to Acute Myocardial Infarction in a Young Woman
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Han Xiongyi
Jeong Myung-Ho
Sim Doo-Sun
Kim Min-Chul
Kim Yong-Cheol
Kim Ju-Han
Hong Young-Joon
Ahn Young-Keun
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Abstract
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Variant angina pectoris (VAP) is a special type of unstable angina with coronary artery spasm as the main pathogenesis, characterized by resting chest pain, and transient ST segment dynamic changes. The development of acute myocardial infarction is not uncommon. We report a case of a 49-year-old female patient diagnosed with VAP at 2 years before who suddenly suffered severe chest pain. Troponin-I was elevated. Immediate coronary angiography showed near-total occlusion in the proximal left anterior descending artery, which was not fully dilated despite use of intracoronary nitroglycerin. Intravascular ultrasound showed focal significant stenosis with a large amount of plaque at the site of spasm and the lesion was successfully treated with drug-eluting stent placement. Intravascular imaging may be instrumental in high-risk patients with VAP who suffer recurrent chest pain despite intensive anti-spasm medications.
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KEYWORD
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Myocardial infarction, Chest pain, Ultrasonics, Variant angina pectoris
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