This case highlights the rare occurrence of vasospasm in a non-culprit coronary artery during hospitalization for SCAD-induced acute myocardial infarction, successfully managed with IVUS-guided stenting.
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IVUS-guided stenting may be feasible in SCAD with non-culprit vasospasm; hypothesis-generating and requires prospective validation before practice change.
We report a case of spontaneous coronary artery dissection (SCAD) causing acute myocardial infarction, which was complicated by vasospastic angina (VA). The patient received intravenous administration of t-PA. Emergency coronary angiography demonstrated narrowing of the left anterior descending artery (LAD) due to SCAD. During hospitalization, the patient suffered chest pain, and ECG showed ST elevation in the inferior leads. Sublingual administration of nitroglycerin provided temporary remission. Coronary stent implantation was performed electively using intravascular ultrasound imaging. This is the first reported case of SCAD associated with vasospasm in a non-culprit coronary artery during the hospitalization.
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Ueda et al. (2006) studied this question.
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