A Case Report of Acute Myocardial Infarction Induced by Coronary Spasm:Intravascular Findings
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概要
- 論文の詳細を見る
A 53-year-old male complaining of chest pain was admitted to our hospital with suspected acute myocardial infarction (AMI). Emergent coronary angiography (CAG) determined a totally occluded middle right coronary artery (RCA). Thrombus aspiration was conducted, followed by intravascular ultrasound (IVUS) imaging. Diffuse intima plus media thickness was identified at the obstruction site and a thrombus was observed proximally to the occlusion site on IVUS. Following isosorbide dinitrate (ISDN) administration, dilatation of the RCA was confirmed. IVUS study indicated the luminal dilatation was achieved by the release of the diffuse intima plus media thickening. Of note, plaque volume showed no significant difference after administration of ISDN at any vessel site. These results clearly show that luminal dilatation and vessel dilatation were achieved from the redistribution of plaque volume (intima plus media). A follow-up CAG showed no significant stenosis in the RCA. After a provocation test using methylergometrine maleate, the RCA was totally occluded at the very site of the initial event. The involvement of vasospasm as a cause of AMI in the present case was doubly confirmed with characteristic IVUS images of vasospasm in the acute phase and with a provocation test at follow-up.
著者
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Kondo Hiroki
Deparment Of Physics Saga University
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Kamikawa Shigeshi
Department Of Cardiology Cardiovascular Center Sakakibara Hospital
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Ota Hideaki
Department Of Cardiology Sakakibara Heart Institute
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Honye Junko
Department Of Cardiology Fuchu Keijin-kai Hospital
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Ueno Katsumi
Department Of Cardiology Gifu Munichipal Hospital
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MATSUO Hitoshi
Department of Cardiology, Gifu Heart Center
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MATSUO HITOSHI
Department of Anatomy, Kurume University School of Medicine
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Miyake Taiji
Department of Cardiology, Gifu Heart Center
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Okubo Munenori
Department of Cardiology, Gifu Heart Center
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Kawase Yoshiaki
Department of Cardiology, Gifu Heart Center
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Tsuchiya Kunihiko
Department of Cardiology, Gifu Heart Center
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