Key result
Intracoronary administration of isosorbide dinitrate successfully relieved simultaneous occlusion of the left anterior descending and left circumflex coronary arteries caused by severe spasm.
Case Report (n=1)
No
Spontaneous and simultaneous multivessel coronary artery spasm can cause life-threatening multisite myocardial infarction, cardiogenic shock, and ventricular fibrillation, which can be successfully managed with intracoronary nitrates and ICD implantation.
May warrant intracoronary nitrates in acute multivessel spasm; case report leaves open need for prospective validation.
A 57-year-old Taiwanese man with a past history of variant angina developed simultaneous anterior and inferior myocardial infarction, atrioventricular block, cardiogenic shock, and eventually ventricular fibrillation. Left coronary angiography revealed simultaneous occlusion of the left anterior descending and the left circumflex coronary arteries, which was relieved by intracoronary administration of isosorbide dinitrate. This is the first report of such a case in the English-language medical literature.
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Chuang et al. (2009) conducted a case report in Multivessel coronary spasm (n=1). Intracoronary isosorbide dinitrate was evaluated on Resolution of coronary artery spasm and ECG abnormalities. Intracoronary administration of isosorbide dinitrate successfully relieved simultaneous occlusion of the left anterior descending and left circumflex coronary arteries caused by severe spasm.
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