Coronary artery spasm: Is ST-elevation key for diagnosis?

Acute Card Care. 2016 Mar;18(1):11-12. doi: 10.1080/17482941.2016.1234057. Epub 2016 Oct 18.

Abstract

Coronary vasospasm is uncommon during pregnancy and the postpartum period. We present a very rare case of an acute coronary vasospasm in a 36-year-old woman who was two weeks postpartum. The coronary arteriograms showed a coronary vasospasm in the distal left anterior descending and circumflex coronary arteries. Electrocardiogram (ECG) presentation was atypical, with T-wave inversions in leads I, aVL, and V2 to V6. To our knowledge, this is the first case with a well-documented coronary artery vasospasm in a postpartum woman without the classic ST elevation on ECG. Management should follow the usual principles of care for acute coronary vasospasm.

Keywords: Coronary vasospasm; ST elevation; postpartum.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Coronary Angiography / methods
  • Coronary Vasospasm* / diagnosis
  • Coronary Vasospasm* / drug therapy
  • Coronary Vasospasm* / etiology
  • Coronary Vasospasm* / physiopathology
  • Diagnosis, Differential
  • Drug Monitoring
  • Echocardiography / methods
  • Electrocardiography / methods*
  • Female
  • Humans
  • Nicardipine / administration & dosage*
  • Nitroglycerin / administration & dosage*
  • Puerperal Disorders* / diagnosis
  • Puerperal Disorders* / drug therapy
  • Puerperal Disorders* / physiopathology
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage

Substances

  • Vasodilator Agents
  • Nicardipine
  • Nitroglycerin