Unstable angina complicated by vasospasm and intracoronary thrombus and no evidence of plaque rupture

International Journal of Cardiology
Seung Hwan HanKyu Hyun Yoon

Abstract

A 57-year-old man came to the emergency room because of abrupt chest pain for 30min. ST elevations in inferior lead were normalized following sublingual nitroglycerin. He performed an exercise test on Bruce protocol and exercised up to 12min (13 METs) without chest pain and ST-T changes on the next day. We performed coronary angiography to rule out coronary vasospasm; however, we did not perform provocation test due to thombus in the culprit lesion. After medical treatment for 6days, follow-up coronary angiogram revealed no thrombus in the previous site and intravascular ultrasound did not demonstrate plaque rupture. We concluded that prolonged spasm might cause prolonged coronary flow limitation and induce acute thrombus formation without plaque rupture. This finding may be an important pathogenesis of acute coronary syndrome in patients with variant angina.

References

Jun 9, 2005·International Journal of Cardiology·Seung Hwan HanEak Kyun Shin

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Citations

Dec 29, 2010·Heart Views : the Official Journal of the Gulf Heart Association·Prashanth Panduranga, Abdullah Amour Riyami
Nov 28, 2006·International Journal of Cardiology·Uygar Cagdas YukselSedat Kose

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