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January 12, 2023Frontiers in Cardiovascular MedicineOpen Access

Case report: A rare manifestation of vasospasm induced myocardial infarction with ST-segment elevation in a young male patient

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Why the study?

A minority of acute myocardial infarctions are caused by non-atherosclerotic coronary artery occlusion, with vasospasm-provoked ST-segment elevation MI being a rare aetiological finding.

Population

One 27-year-old male patient presenting with chest pain radiating to the left arm

Design

Case report

Authors

LDLaurynas DiečkusVilnius UniversityGRGreta RodevičABArvydas BaranauskasVilnius University

Discussion

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Implication

Consider vasospasm in young STEMI without atherosclerosis; case report leaves open optimal management strategies.

Structured PICO

P
Population
27-year-old male patient presenting with sudden onset chest pain radiating to the left arm, with a history of percutaneous coronary intervention (PCI) to the right coronary artery (RCA) 3 months prior due to inferior wall MI.
I
Intervention
Intracoronary administration of nitrates and verapamil during coronary angiography, followed by oral long-acting nitrates and diltiazem.
O
Outcome
Relief of coronary artery spasm and cessation of angina episodes.

Highlights the importance of using intracoronary nitroglycerine during coronary angiography to correctly diagnose vasospasm-induced MI and prevent unnecessary stenting.

Cite This Study

Diečkus et al. (2023) studied this question.

synapsesocial.com/papers/6a701fa95d37378ac1dd3186https://doi.org/10.3389/fcvm.2022.1017107
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Also Consider

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  1. 1High incidence of provoked coronary spasm in the presence of a stent after myocardial infarction2012 · 19 citations
  2. 2Angiotensin converting enzyme as a genetic risk factor for coronary artery spasm. Implication in the pathogenesis of myocardial infarction.1995 · 65 citations
  3. 3ST-Elevation Myocardial Infarction After Sumitriptan Ingestion in Patient with Normal Coronary Arteries2015 · 10 citations
  4. 4Myocardial infarction redefined—a consensus document of The Joint European Society of Cardiology/American College of Cardiology committee for the redefinition of myocardial infarction2000 · 4,856 citations
  5. 5Coronary Artery Spasm: New Insights2020 · 108 citations