Abstract
We describe a 59-year-old patient presenting with ST-elevation acute coronary syndrome. Coronary angiography with intravascular ultrasound (IVUS) showed an important nonsignificant atherosclerotic lesion in the proximal left anterior descending artery (LAD) and presence of bridging in the mid-LAD. Our hypothesis was that focal spasm at this site was the cause of transmural ischaemia; therefore, treatment was given by performing a percutaneous coronary intervention (PCI) of the lesion. The patient remained symptom-free which confirmed our conclusion. The myocardial bridging had no clinical implications at this moment.
References
Cannon CP, Braunwald E. Braunwald’s Heart Disease 7th edition. Elsevier Saunders. 2005; 49: 1264–7.
Saito S, Yamagishi M, Takayama T, et al. Plaque morphology at coronary sites with focal spasm in variant angina. Circ J. 2003;67:1041–5.
Tsujita K, Maehara A, Mintz GS, et al. Comparison of angiographic and intravascular ultrasonic detection of myocardial bridging of the left anterior descending coronary artery. Am J Cardiol. 2008;102:1608–13.
Möhlenkamp S, Hort W, Junbo G, et al. Update on myocardial bridging. Circulation. 2002;106:2616–22.
Ge J, Erbel HJ, Rupprecht HJ, et al. Comparison of intravascular ultrasound and angiography in the assessment of myocardial bridging. Circulation. 1994;89:1725–32.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Denham, R.N., Appelman, Y.E. & Verdel, G.J.E. A cataclasm due to spasm. Neth Heart J 21, 44–46 (2013). https://doi.org/10.1007/s12471-012-0328-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12471-012-0328-0