(14) identified a NOS3 gene polymorphism in the 5' flanking region (T786C) that was significantly associated with coronary spasm
Increased adventitial mast cells in a patient with coronary spasm
. N Engl J Med 1985; 313:1138-41.
(1988) Hyperventilation-induced simultaneous multivessel coronary spasm
in patients with variant angina: An echocardiographic and arteriographic study.
Achuff, "Coronary spasm
with fibrillation during thyrotoxicosis: response to attaining euthyroid state," American Journal of Cardiology, vol.
was the first manifestation in this patient that manifested as cardiogenic shock due to an acute coronary syndrome in a background of normal epicardial coronary vessels.
Precipitating factors contributing to the onset of angina Prinzmetal are greatly varied even for the same patient: physical and mental stress, alcohol, hyperventilation, deficiency in magnesium, Valsalva maneuver and the administration of pharmacological agents being known to determine coronary spasm
(Hung MY 2013; Hung MJ 2014).
B-blockers, however, should be avoided as they may exaggerate coronary spasm
Severe coronary spasm
and poor relationship with other non-invasive methods of detecting coronary spasm
Nosaka et al., "Progression of coronary atherosclerosis: is coronary spasm
related to progression?" Journal of the American College of Cardiology, vol.
The bradycardia and hypotension occurred before the catheter engagement of coronary arteries in our cases which suggest these consequences are unlikely due to catheter-induced coronary spasm
. When we advance the Guidewire, we may encounter coiling in the blood vessels due to the tortuosity of the vasculature (Figure 1).
Sympathetic hyperactivity itself also contributes to a higher risk of coronary spasm
, and coronary thrombosis.3 However, the association of atherosclerotic risk factors with the thrombus composition in treated patients of ST elevation myocardial infarction (STEMI) has not been previously analysed.
It manifests as coronary spasm
, acute myocardial infarction and stent thrombosis, and affects the cerebral, mesenteric and coronary arteries.
Intracoronary (IC) nitroglycerine was administered when the hemodynamics permitted to exclude any epicardial coronary spasm
. IC anti no-reflow medications were given according to the need.
Alternative diagnosis was coronary spasm
(n = 7), peri-myocarditis (n = 6), apical ballooning syndrome (n = 3), anaphylactic shock (n = 1).
Multivessel coronary spasm
presenting with acute myocardial infarction complicated by complete heart block or recurrent ventricular fibrillation and cardiogenic shock though rare has been reported previously.