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Clinical Research in Cardiology

, Volume 105, Issue 7, pp 636–638 | Cite as

The “spastic” coronary plaque: dynamic deformation of an atheromatous plaque demonstrated by optical coherence tomography

  • Anca Florian
  • Dieter Fischer
  • Ali Yilmaz
Letter to the Editors

Sirs:

A 65-year-old female suffering from dyspnea and chest pain—that occurred primarily during exercise (but sometimes also at rest) for a few months—presented to our hospital for further invasive work-up by coronary angiography. During an exercise treadmill test (performed in an outpatient setting) the aforementioned symptoms were reproduced, however, without any significant ST/T-wave abnormalities. She had a positive family history for presence of coronary artery disease (CAD) and was on anti-hypertensive medication for a few years. She was in a quite good general condition and her physical examination was unremarkable. Blood analysis revealed normal cardiac enzymes and brain natriuretic peptide (BNP) values. Her resting ECG demonstrated sinus rhythm without any repolarization abnormalities.

After stopping her current medication (comprising aspirin, a β-blocker and a nitrate) for more than 12 h, an invasive multiplane coronary angiography was performed. First, the left coronary...

Keywords

Optical Coherence Tomography Left Anterior Descend Brain Natriuretic Peptide Left Coronary Artery Coronary Plaque 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with ethical standards

Conflict of interest

None.

Supplementary material

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Supplementary material 1 (AVI 5589 kb) Movie 1 – Coronary angiography of the left coronary artery at baseline
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Supplementary material 2 (AVI 5448 kb) Movie 2 – Coronary angiography of the left coronary artery after administration of nitroglycerin
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Supplementary material 3 (AVI 5872 kb) Movie 3 – Coronary angiography of the left coronary artery after positioning of the optical coherence tomography catheter
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Supplementary material 4 (AVI 5519 kb) Movie 4 – Coronary angiography of the left coronary artery after positioning of the optical coherence tomography catheter and additional administration of nitroglycerin
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Supplementary material 5 (AVI 4953 kb) Movie 5 – Coronary angiography of the right coronary artery

References

  1. 1.
    Yilmaz A, Hill S, Schaufele T, Vohringer M, Geissler A, Sechtem U (2010) Exercise-induced spastic coronary artery occlusion at the site of a moderate stenosis: neither Prinzmetal’s angina nor cardiac syndrome X but “Prinzmetal X”. Circulation 122:e570–e574CrossRefPubMedGoogle Scholar
  2. 2.
    Lanza GA, Careri G, Crea F (2011) Mechanisms of coronary artery spasm. Circulation 124:1774–1782CrossRefPubMedGoogle Scholar
  3. 3.
    Prinzmetal M, Kennamer R, Merliss R, Wada T, Bor N (1959) Angina pectoris. I. A variant form of angina pectoris; preliminary report. Am J Med 27:375–388CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of Cardiovascular MedicineUniversity Hospital MünsterMünsterGermany

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