DOI QR코드

DOI QR Code

Cardiogenic Shock From Global Myocardial Ischemia Induced by Simultaneous Multivessel Coronary Spasm

  • Ahn, Ji-Hye (Department of Internal Medicine, Dong-A University School of Medicine) ;
  • Kim, Bo-Sung (Department of Internal Medicine, Dong-A University School of Medicine) ;
  • Park, Hye-Kyong (Department of Internal Medicine, Dong-A University School of Medicine) ;
  • Park, Kyung-Il (Department of Internal Medicine, Dong-A University School of Medicine) ;
  • Kim, Young-Dae (Department of Internal Medicine, Dong-A University School of Medicine)
  • 발행 : 2012.06.30

초록

Coronary artery spasm is an uncommon, but well recognized, etiology for acute myocardial infarction. However, cardiogenic shock with myocardial infarction resulting from simultaneous multiple coronary artery spasm has been rarely reported, and not in Korea. Recently, we experienced such a case in a 50-year-old Korean man without previous diagnosis of variant angina. The patient, hospitalized for blood sugar control, developed severe chest pain accompanying ST-segment elevation in multiple leads. The patient immediately received cardiac catheterization because of cardiogenic shock. Coronary angiogram revealed the severe and simultaneous spasm of three major epicardial arteries, which was promptly relieved by an intracoronary administration of isosorbide dinitrate. This case highlights the need to rule out the potential mechanism of coronary spasm even in the most severe episodes of acute coronary syndrome.

키워드

참고문헌

  1. Lange RL, Reid MS, Tresch DD, Keelan MH, Bernhard VM, Coolidge G. Nonatheromatous ischemic heart disease following withdrawal from chronic industrial nitroglycerin exposure. Circulation 1972;46:666-78. https://doi.org/10.1161/01.CIR.46.4.666
  2. Severi S, Davies G, Maseri A, Marzullo P, L'Abbate A. Long-term prognosis of "variant" angina with medical treatment. Am J Cardiol 1980;46: 226-32. https://doi.org/10.1016/0002-9149(80)90062-4
  3. Waters DD, Szlachcic J, Miller D, Theroux P. Clinical characteristics of patients with variant angina complicated by myocardial infarction or death within 1 month. Am J Cardiol 1982;49:658-64. https://doi.org/10.1016/0002-9149(82)91943-9
  4. Waters DD, Miller D, Szlachcic J, et al. Factors influencing the longterm prognosis of treated patients with variant angina. Circulation 1983; 68:258-65. https://doi.org/10.1161/01.CIR.68.2.258
  5. Mark DB, Califf RM, Morris KG, et al. Clinical characteristics and longterm survival of patients with variant angina. Circulation 1984;69:880-8. https://doi.org/10.1161/01.CIR.69.5.880
  6. Jeoung JY, Lim DS, Kang JA, et al. The study of coronary spasm by follow- up coronary angiography in variant angina. Korean Circ J 2002;32: 791-7.
  7. Doo YC, Kim JS, Chae KS, et al. Clinical and angiographic characteristics and long-term follow-up in patients with variant angina who presented as acute myocardial infarction. Korean Circ J 1999;29:276-84. https://doi.org/10.4070/kcj.1999.29.3.276
  8. Leary T. Coronary spasm as a possible factor in producing sudden death. Am Heart J 1935;10:338-44. https://doi.org/10.1016/S0002-8703(35)90315-5
  9. Saito H, Itoh T, Itoh M, Kanaya Y, Suzuki T, Hiramori K. Simultaneous multivessel coronary spasm causing acute myocardial infarction: a case report. Angiology 2007;58:112-7. https://doi.org/10.1177/0003319706297967
  10. Vincent GM, Anderson JL, Marshall HW. Coronary spasm producing coronary thrombosis and myocardial infarction. N Engl J Med 1983; 309:220-3. https://doi.org/10.1056/NEJM198307283090406
  11. Meisel SR, Mazur A, Chetboun I, et al. Usefulness of implantable cardioverter- defibrillators in refractory variant angina pectoris complicated by ventricular fibrillation in patients with angiographically normal coronary arteries. Am J Cardiol 2002;89:1114-6. https://doi.org/10.1016/S0002-9149(02)02283-X
  12. Golzio PG, Orzan F, Ferrero P, et al. Myocardial infarction with normal coronary arteries: ten-year follow-up. Ital Heart J 2004;5:732-8.
  13. Da Costa A, Isaaz K, Faure E, Mourot S, Cerisier A, Lamaud M. Clinical characteristics, aetiological factors and long-term prognosis of myocardial infarction with an absolutely normal coronary angiogram; a 3- year follow-up study of 91 patients. Eur Heart J 2001;22:1459-65. https://doi.org/10.1053/euhj.2000.2553