Key result
Continuous intracoronary nitroglycerin resolves recurrent post-angioplasty coronary artery spasm in a single patient.
Why the study?
Does continuous intracoronary infusion of nitroglycerin alleviate recurrent coronary artery spasm after angioplasty in a patient unresponsive to other routes?
Case Report (n=1)
Does continuous intracoronary infusion of nitroglycerin alleviate recurrent coronary artery spasm after angioplasty in a patient unresponsive to other routes?
Continuous intracoronary nitroglycerin infusion may be an effective rescue therapy for recurrent coronary artery spasm in the catheterization laboratory.
May warrant rescue use for refractory spasm in the lab; leaves open confirmation in prospective studies.
A patient with reversible coronary artery spasm superimposed on fixed atherosclerotic coronary disease was treated with percutaneous transluminal angioplasty. The procedure successfully dilated the atherosclerotic lesion. However, 20 minutes later, the patient developed coronary artery spasm at the angioplasty site. Sublingual nitroglycerin, sublingual nifedipine, intravenous nitroglycerin, and repeated boluses of intracoronary nitroglycerin alleviated episodes of spasm, but failed to prevent recurrence. The patient was successfully treated with a continuous intracoronary infusion of nitroglycerin. Patients with coronary artery spasm in addition to fixed obstructive coronary disease may be at higher risk for spasm after percutaneous transluminal angioplasty. Continuous intracoronary infusion of nitroglycerin may be an effective therapy for recurrent coronary artery spasm occurring in the catheterization laboratory.
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Kern et al. (1983) conducted a case report in Coronary artery spasm after percutaneous transluminal angioplasty (n=1). Continuous intracoronary nitroglycerin infusion was evaluated on Alleviation of recurrent coronary artery spasm. Continuous intracoronary infusion of nitroglycerin successfully treated recurrent coronary artery spasm occurring after percutaneous transluminal angioplasty in a single patient.
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