Coronary artery spasm – one medical entity with different treatment options

Vladimir Zdravković; Rada Vučić; Miodrag Srećković; Ivan Simić; Vojislav Mitrović; Dragan Dinčić; Slavko Knežević; Nemanja Zdravković

doi:10.2298/VSP160405385Z

Vladimir Zdravković University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Rada Vučić University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Miodrag Srećković University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Ivan Simić University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Vojislav Mitrović Klinikum Coburg, GmbH, Department of Cardiology, Coburg, Germany
Dragan Dinčić Military Medical Academy, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Slavko Knežević Clinical Center Kragujevac, Department of Internal Medicine, Kragujevac, Serbia
Nemanja Zdravković University of Kragujevac, Faculty of Medical Sciences, Center for Molecular Medicine and Stem Cell Research, Kragujevac, Serbia

DOI: https://doi.org/10.2298/VSP160405385Z

Keywords: myocardial infarction;, coronary vasospasm;, therapeutics;, verapamil;, angioplasty, transluminal, percutaneous, coronary.

Abstract

Abstract

Introduction. Myocardial infarction (MI) is characterized by a critical myocardial ischemia followed by an irreversible myocardial cell damage or death. Case report. We presented two similar clinical cases with the ST segment elevation myocardial infarction (STEMI) diagnosis due to a prolonged coronary artery spasm, but with different treatment options due to different basic patophysiological supstrates and clinical presentations. Conclusion. Coronary artery spasm is a very complex pathophysiological entity with a different medication therapy management. Although the percutaneous coronary intervention can be the first choice, the treatment strategy should be carefully planned.

Author Biography

Rada Vučić, University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia

Department of cardiology - interventional cardiologist

Faculty of medical sciences - assistant

References

REFERENCES

Thygesen K, Alpert JS, White HD. Universal Deﬁnition of Myo-cardial Infarction. J Am Coll Cardiol 2007; 50(22): 2173‒95.

Ong P, Athanasiadis A, Hill S, Vogelsberg H, Voehringer M, Sechtem U. Coronary Artery Spasm as a Frequent Cause of Acute Coronary Syndrome. The CASPAR (Coronary Ar¬tery Spasm in Patients With Acute Coronary Syndrome) Study. J Am Coll Cardiol 2008; 52(7): 523‒7.

Lanza GA, Carreri G, Crea F. Mechanisms of Coronary Ar¬tery Spasm. Circulation 2011; 124(16): 1774‒82.

Wang LX, Lü SZ, Zhang WJ, Song XT, Chen H, Zhang LJ. Cor-onary spasm, a pathogenic trigger of vulnerable plaque rup-ture. Chin Med J 2011; 124(23): 4071‒8.

Steg G, James SK, Atar D, Badano LP, Blomstrom-Lundqvist C, Borger MA, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012; 33(20): 2569‒619.

Giacoppo D, Baber U, Mehran R. Current developments in dual antiplatelet therapy after stenting. Minerva Cardioan¬giologica 2014; 62(3): 261‒76.

Kaneda H, Taguchi J, Kuwada Y, Hangaishi, Aizawa T, Ya¬makado M, et al. Coronary artery spasm and the polymor¬phisms of the endothelial nitric oxide synthase gene. Circ J 2006; 70(4): 409–13.

Kandabashi T, Shimokawa H, Miyata K, Kunihiro I, Kawano Y, Fu-kata Y, et al. Inhibition of myosin phosphatase by upregulated Rho-kinase plays a key role for coronary ar¬tery spasm in a por-cine model with interleukin-1beta. Cir¬culation 2000; 101(11): 1319–23.

Otsuka F, Sakakura S, Virmani R. Are mast cells the real cul-prit in atherosclerosis? Eur Heart J 2013; 34(48): 3681‒3.

Zdravkovic V, Pantovic S, Rosic G, Tomic Lucic A, Zdravk¬ovic N, Colic M, et al. Histamine Blood Concentration in Ischemic Heart Disease Patients. J Biomed Biotechnol 2011; 2011: 315709.

Teragawa H, Kato M, Yamagata T, Matsuura H, Kajiyama G. The preventive effect of magnesium on coronary spasm in patients with vasospastic angina. Chest 2000; 118(6): 1690‒5.