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January 1, 2005International Heart JournalOpen Access

A Case of Recurrent Chest Pain With Reversible Left Ventricular Dysfunction and ST Segment Elevation on Electrocardiogram

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Population

67-year-old female with recurrent chest pain, reversible left ventricular dysfunction, and ST segment…

Comparison

Intracoronary acetylcholine administration with… vs Nonischemic control subjects for the IC-ACh…

Design

Case_report

Authors

HYHiroyuki YaoitaTYTakayoshi YamakiHMHiroyuki Mizugami

Discussion

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Overview

May implicate microvascular spasm in apical ballooning; hypothesis-generating and requires prospective confirmation before practice change.

Structured PICO

P
Population
67-year-old female with recurrent chest pain, reversible left ventricular dysfunction, and ST segment elevation on ECG without epicardial coronary artery obstruction (transient left ventricular apical ballooning syndrome).
I
Intervention
Intracoronary acetylcholine administration (IC-ACh) with Doppler flow wire measurement of average peak flow velocity (APFV), and subsequent treatment with a Ca antagonist and KATP opener.
C
Comparator
Nonischemic control subjects (n=24) for the IC-ACh response.
O
Outcome
Change in average peak flow velocity (APFV) of the left coronary artery in response to intracoronary acetylcholine.surrogate

This case suggests that coronary microvascular spasm may contribute to the pathophysiology of transient left ventricular apical ballooning syndrome, which can be managed with calcium antagonists and KATP openers.

Cite This Study

Yaoita et al. (2005) studied this question.

synapsesocial.com/papers/6a710e006c240de38cdc064bhttps://doi.org/10.1536/ihj.46.147
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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  5. 5Microvascular Angina Accompanied by Epicardial Coronary Artery Spasm.2002 · 2 citations