ABSTRACT
The case of a 30-year-old man with myocardial infarction localized in the interventricular septum is described. Coronary angiography performed on day 28 after the onset of symptoms revealed ectasia in the right and left coronary arteries, but no overt stenotic or occlusive lesions were present. Spasm was induced in the first septal branch of the left anterior descending artery by an acetylcholine provocation test, and single photon emission computed tomography myocardial perfusion imaging showed a reduced thallium-201 uptake localized in the interventricular septum.
Subject(s)
Coronary Artery Disease/diagnosis , Myocardial Infarction/diagnosis , Adult , Coronary Angiography , Coronary Artery Disease/complications , Coronary Vasospasm/complications , Dilatation, Pathologic , Electrocardiography , Heart Conduction System , Humans , Male , Myocardial Infarction/etiology , Tomography, Emission-Computed, Single-Photon , Ventricular SeptumABSTRACT
It is unusual for coronary vasospasm to develop following angioplasty of a coronary vascular lesion that is located elsewhere. We experienced a rare case of shock with vasospasm of the right coronary artery in a patient following balloon angioplasty performed for stent restenosis of the left anterior descending artery.
Subject(s)
Angioplasty, Balloon, Coronary/adverse effects , Coronary Restenosis/therapy , Coronary Vasospasm/etiology , Aged , Angina Pectoris/etiology , Angioplasty, Balloon, Coronary/instrumentation , Antihypertensive Agents/therapeutic use , Cardiac Pacing, Artificial , Coronary Angiography , Coronary Restenosis/diagnostic imaging , Coronary Vasospasm/diagnostic imaging , Coronary Vasospasm/therapy , Electrocardiography , Female , Humans , Shock/etiology , Stents , Treatment Outcome , Vasodilator Agents/therapeutic useABSTRACT
A volumetric analysis by 3-dimensional intravascular ultrasound revealed that lipid-lowering therapy with pravastatin significantly reduced coronary plaque volume. The changes in plaque volume were inversely correlated with the changes in plasma levels of high-density lipoprotein cholesterol but not with changes in levels of total cholesterol or low-density lipoprotein cholesterol.
