Multi-vessel intractable coronary spasm development in a patient with aborted sudden cardiac death: a case study with intravascular ultrasound findings
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Coronary spasm generally occurs in patients with minimal atherosclerotic plaque lesion, and it has a rather favorable prognosis. However, in some cases, coronary spasm may induce myocardial infarction and even sudden cardiac death (SCD). Here, we report a case in which multi-vessel intractable coronary vasospasm suddenly occurred in a diffuse atherosclerotic lesion after percutaneous coronary intervention (PCI) in a patient with aborted SCD. We identified the characteristics of the spasm portion in intravascular ultrasound (IVUS) images and conducted percutaneous cardiopulmonary bypass support-PCI with stenting as treatment. Intima and media thickening and a large attenuated plaque burden with rupture were identified in IVUS images at the obstructive spasm portion.
Abstract
Coronary spasm generally occurs in patients with minimal atherosclerotic plaque lesion, and it has a rather favorable prognosis. However, in some cases, coronary spasm may induce myocardial infarction and even sudden cardiac death (SCD). Here, we report a case in which multi-vessel intractable coronary vasospasm suddenly occurred in a diffuse atherosclerotic lesion after percutaneous coronary intervention (PCI) in a patient with aborted SCD. We identified the characteristics of the spasm portion in intravascular ultrasound (IVUS) images and conducted percutaneous cardiopulmonary bypass support-PCI with stenting as treatment. Intima and media thickening and a large attenuated plaque burden with rupture were identified in IVUS images at the obstructive spasm portion.
참고문헌 (9)
- JCS Joint Working Group, "Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary Spastic Angina) (JCS 2013)", Circ J, 78, pp.2779~2801 (2014)[DOI]
- Yamagishi M, "Intravascular ultrasound detection of atherosclerosis at the site of focal vasospasm in angiographically normal or minimally narrowed coronary segments", J Am Coll Cardiol, 23, pp.352~357 (1994)[DOI]
- Yasue H, "Long-term prognosis for patients with variant angina and influential factors", Circulation, 78, pp.1~9 (1988)[DOI]
- Myerburg RJ, "Life-threatening ventricular arrhythmias in patients with silent myocardial ischemia due to coronaryartery spasm", N Engl J Med, 326, pp.1451~1455 (1992)[DOI]
- Bhagwat A, "Severe generalized resistant spasm of the right coronary artery causing hemodynamic collapse after stenting", JACC Cardiovasc Interv, 8, pp.e199~e200 (2015)[DOI]
- Miyao Y, "Diffuse intimal thickening of coronary arteries in patients with coronary spastic angina", J Am Coll Cardiol, 36, pp.432~437 (2000)[DOI]
- Ota H, "A case report of acute myocardial infarction induced by coronary spasm. Intravascular findings", Int Heart J, 54, pp.237~239 (2013)[DOI]
- Park YM, "Repeated sudden cardiac death in coronary spasm: is IVUS helpful to decide treatment strategy?", Int J Cardiol, 154, pp.e57~e59 (2012)[DOI]
- Shin ES, "OCT-defined morphological characteristics of coronary artery spasm sites in vasospastic angina", JACC Cardiovasc Imaging, 8, pp.1059~1067 (2015)[DOI]