Coronary artery spasm: a Quandary

Coronary artery spasm can result in acute coronary syndrome. This vasospastic syndrome can cause profound morbidity and mortality as a significant proportion of patients continue to have angina despite optimal medical therapy. We illustrate the dilemma in managing a young woman who presented with...

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Main Authors: Ngow, Harris Abdullah, Wan Mohd Nowalid, Wan Khairina
Format: Article
Language:English
Published: 2011
Subjects:
Online Access:http://irep.iium.edu.my/5107/
http://irep.iium.edu.my/5107/1/IMJMVol10No1_pg53-55.pdf
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author Ngow, Harris Abdullah
Wan Mohd Nowalid, Wan Khairina
author_facet Ngow, Harris Abdullah
Wan Mohd Nowalid, Wan Khairina
author_sort Ngow, Harris Abdullah
building IIUM Repository
collection Online Access
description Coronary artery spasm can result in acute coronary syndrome. This vasospastic syndrome can cause profound morbidity and mortality as a significant proportion of patients continue to have angina despite optimal medical therapy. We illustrate the dilemma in managing a young woman who presented with non ST-segment myocardial infarction as a result of it. She did not have the conventional risks for coronary artery disease except the family history of myocardial infarction. Vasospasm was demonstrated at the mid right coronary artery which resolved with intracoronary nitroglycerine during angiogram. Most women with no significant heart disease following demonstration of normal or “near normal” coronary arteries after angiography are offered no treatment beyond reassurance each year. New data suggest that this approach may no longer be appropriate and the prognosis in such patient is not as benign as previously thought. We discuss the management dilemma of such patient with associated mild atherosclerotic plaque.
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spelling iium-51072011-10-28T04:51:58Z http://irep.iium.edu.my/5107/ Coronary artery spasm: a Quandary Ngow, Harris Abdullah Wan Mohd Nowalid, Wan Khairina R Medicine (General) RC Internal medicine Coronary artery spasm can result in acute coronary syndrome. This vasospastic syndrome can cause profound morbidity and mortality as a significant proportion of patients continue to have angina despite optimal medical therapy. We illustrate the dilemma in managing a young woman who presented with non ST-segment myocardial infarction as a result of it. She did not have the conventional risks for coronary artery disease except the family history of myocardial infarction. Vasospasm was demonstrated at the mid right coronary artery which resolved with intracoronary nitroglycerine during angiogram. Most women with no significant heart disease following demonstration of normal or “near normal” coronary arteries after angiography are offered no treatment beyond reassurance each year. New data suggest that this approach may no longer be appropriate and the prognosis in such patient is not as benign as previously thought. We discuss the management dilemma of such patient with associated mild atherosclerotic plaque. 2011-06 Article PeerReviewed application/pdf en http://irep.iium.edu.my/5107/1/IMJMVol10No1_pg53-55.pdf Ngow, Harris Abdullah and Wan Mohd Nowalid, Wan Khairina (2011) Coronary artery spasm: a Quandary. International Medical Journal Malaysia, 10 (1). pp. 53-55. ISSN 1823-4631 http://iiumedic.com/eimj/v1/?p=218
spellingShingle R Medicine (General)
RC Internal medicine
Ngow, Harris Abdullah
Wan Mohd Nowalid, Wan Khairina
Coronary artery spasm: a Quandary
title Coronary artery spasm: a Quandary
title_full Coronary artery spasm: a Quandary
title_fullStr Coronary artery spasm: a Quandary
title_full_unstemmed Coronary artery spasm: a Quandary
title_short Coronary artery spasm: a Quandary
title_sort coronary artery spasm: a quandary
topic R Medicine (General)
RC Internal medicine
url http://irep.iium.edu.my/5107/
http://irep.iium.edu.my/5107/
http://irep.iium.edu.my/5107/1/IMJMVol10No1_pg53-55.pdf