MINOCA Resulting from Coronary Spasm Confirmed Angiographically without Ergonovine Stimulation: A Case Report

Introduction: Myocardial infarction with nonobstructive coronary arteries disease (MINOCA) encompasses a heterogeneous group of disorders. Multimodality imaging is crucial to figure out the underlying mechanism. Coronary artery spasm common cause MINOCA and might be difficult identify. Case Presentation: A 43-year-old male no cardiovascular risk factor presented prolonged acute chest pain at 5 am that resolved spontaneously. On admission, he was asymptomatic clinical findings were unremarkable. The electrocardiogram showed an anterolateral negative T wave. troponin positive. angiography (CA) revealed moderate lesion proximal left anterior descending (LAD) artery. He treated dual antiplatelet therapy, statin, beta-blocker favourable hospital course. One week later, recurrences ST-segment elevation. CA, without intra-radial nitrate, owing vasospasm suspicion, sub-occlusion LAD which after intracoronary nitrates. Chest elevation then disappeared. remained discharged on CCB (calcium channel blocker), long-acting nitrates statin. Cardiac magnetic resonance (CMR) demonstrated ejection fraction (EF) 45% ischemia. Conclusion: Our case about MINOCA, namely spasm, diagnosed by angiogram provocative test.