To investigate whether ergonovine acts directly on coronary arteries or via remote neurohumoral reflexes, we administered small titrated increments of intracoronary ergonovine up to a maximum cumulative dose of 50 micrograms to 15 patients. In six patients with variant angina (group 1), ischemic electrocardiographic ST changes, angina, and localized coronary spasm (local coronary diameter reduc...

BACKGROUND Myocardial bridge refers to the myocardial tissue with which the coronary artery is partly covered. Though it has long been regarded to be benign, patients with myocardial bridges may present with myocardial ischemia, acute coronary syndromes, coronary spasm, sudden cardiac arrest or even sudden death. CASE PRESENTATION In present study, we reviewed four cases with myocardial bridg...

Myocardial ischaemia results from a direct mismatch between oxygen supply and demand, commonly arising as a result of coronary atherosclerosis, microvascular dysfunction or acute thrombosis and luminal obstruction. However, transient ischaemia may also occur due to coronary spasm leading to acute and unexpected myocardial ischaemia without obvious visible coronary pathology. Aside from symptoms...

Dobutamine stress echocardiography is widely performed as a useful diagnostic tool in patients with known or suspected coronary artery disease. Dobutamine induced myocardial ischaemia is frequently associated with ST segment depression. ST segment elevation is uncommon and is almost always associated with prior myocardial infarction or transient total coronary occlusion. Dobutamine induced ST s...

Middle-aged female patients with systemic lupus erythematosus (SLE) have an increased risk of coronary artery disease and myocardial infarction (MI). We report a case of left anterior descending coronary artery (LAD) MI associated with severe coronary spasm in both the LAD and left circumflex artery, complicated with fracture of the distal wire within the microcatheter which was successfully re...

Hyperthyroidism is associated with many heart diseases. Thyrotoxic state has a relationship with coronary spasm. We present a case of a non-menopausal woman with hyperthyroidism who complained of chest pain. The diagnosis of coronary spasm was confirmed by coronary angiography (CAG). She is treated well with anti-thyrotoxicosis and anti-anginal medication. We recommend not use CAG as the first ...

A case is presented, believed to be the first reported, describing recurrent myocardial infarction in an athletic 25-year-old man due to coronary arterial spasm, which was demonstrated at autopsy. A previous angiogram performed during life, after the first myocardial infarction, showed normal coronary arteries. The findings in this case are discussed with a review of the current knowledge perta...

Although there are a number of studies on vasospastic angina, the structural changes at the cellular level that occur in the coronary arterial wall during spasm are not well known. Coronary spasm was induced by brushing the coronary adventitia in nine anesthetized beagles, and structural changes in the spastic coronary segments were examined by light and electron microscopy, making comparisons ...

In 1959, Prinzmetal and colleagues described a new form of chest pain that developed at rest and very often occurred in the early morning hours.12 The pain was associated with ST segment elevations in the electrocardiogram and relieved by nitroglycerin. They named the syndrome "variant angina" and suggested that it was caused by a spasm of a major epicardial coronary artery. Subsequently, coron...

25 Myocardial bridge refers to the myocardial tissue with which the coronary artery is 26 partly covered. Though it has long been regarded to be benign, patients with 27 myocardial bridges may present with myocardial ischemia, acute coronary syndromes, 28 coronary spasm, sudden cardiac arrest or even sudden death. In present study, we 29 reviewed four cases with myocardial bridge and no stenosi...