Prinzmetal angina: An unrecognized cause of recurrent ST elevation myocardial infarction

Pratik Choksy, Rebecca Napier, Gyanendra Kumar Sharma

Research output: Contribution to journalArticle

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Abstract

Background: Prinzmetal's angina is characterized by a transient reduction in luminal diameter of a coronary artery resulting in spontaneous and often recurrent episodes of angina with electrocardiography (ECG) findings consistent with ST elevation. Case report: A 67-year-old male presented with complaint of intermittent chest discomfort during the previous 2-3 weeks. ECG obtained at presentation was consistent with ST elevation in inferior leads. The patient underwent urgent cardiac catheterization with uncomplicated balloon angioplasty to proximal and distal right coronary artery (RCA). At two-week follow up, the patient continued to complain of recurrent chest discomfort with repeat ECG showing ST elevation in inferior leads. He was given nitroglycerin with symptomatic improvement and gradual resolution of ST elevation. Given concern for reocclusion, the patient again underwent urgent cardiac catheterization showing subtotal occlusion of the proximal RCA. During the procedure, intracoronary nitroglycerin was administered with visible resolution of the occlusion via angiography consistent with coronary vasospasm. The patient was therefore initiated on therapy with amlodipine and isosorbide mononitrate and remained symptom free at subsequent follow-up visits. Conclusion: Prinzmetal's angina is a well-documented but under-recognized etiology of recurrent ST elevation myocardial infarction which should be considered in those with both typical and atypical cardiovascular risk profiles.

Original languageEnglish (US)
JournalJournal of Cardiology Cases
Volume6
Issue number5
DOIs
StatePublished - Nov 1 2012

Fingerprint

Variant Angina Pectoris
Coronary Vessels
Electrocardiography
Nitroglycerin
isosorbide-5-mononitrate
Cardiac Catheterization
Thorax
Coronary Vasospasm
Amlodipine
Balloon Angioplasty
Angiography
ST Elevation Myocardial Infarction

Keywords

  • Coronary vasospasm
  • Prinzmetal angina
  • ST elevation myocardial infarction
  • Variant angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prinzmetal angina : An unrecognized cause of recurrent ST elevation myocardial infarction. / Choksy, Pratik; Napier, Rebecca; Sharma, Gyanendra Kumar.

In: Journal of Cardiology Cases, Vol. 6, No. 5, 01.11.2012.

Research output: Contribution to journalArticle

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