Left anterior descending coronary artery spasm and "accordion effect" mimicking coronary artery dissection

Medicina (Kaunas). 2014;50(5):309-11. doi: 10.1016/j.medici.2014.10.004. Epub 2014 Oct 29.

Abstract

We present an illustrative case report of the mid-vessel left anterior descending (LAD) coronary artery spasm, which has been enhanced by straightening of the tortuous LAD segment with a guidewire ("accordion effect") thus resistant to intracoronary nitroglycerine and mimicking a coronary artery dissection. Dynamic appearance of this iatrogenic pseudo-lesion upon administration of intracoronary nitrates and recognition of these angiographic phenomena prevented from unnecessary further intervention.

Keywords: Accordion phenomenon; Coronary artery spasm; Percutaneous coronary intervention.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Carotid Artery, Internal, Dissection / diagnosis*
  • Carotid Artery, Internal, Dissection / diagnostic imaging
  • Carotid Artery, Internal, Dissection / etiology*
  • Coronary Angiography
  • Coronary Stenosis / diagnosis*
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / etiology*
  • Coronary Vessels / injuries*
  • Diagnosis, Differential
  • Female
  • Humans
  • Iatrogenic Disease
  • Nitroglycerin / administration & dosage
  • Stents / adverse effects
  • Vasodilator Agents / administration & dosage

Substances

  • Vasodilator Agents
  • Nitroglycerin