Journal of Yeungnam Medical Science

Case Reports

Multi-vessel intractable coronary spasm development in a patient with aborted sudden cardiac death: a case study with intravascular ultrasound findings: Sungsoo Cho, Tae Soo Kang; Yeungnam Univ J Med. 2018;35(1):121-126. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.121

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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.

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Intractable right coronary artery spasm in the early postoperative period after heart transplantation: a case report
Jaewook Chung, Jeehoon Kang, Hae-Young Lee, Suk Ho Sohn, Ho Young Hwang, Hyun-Jai Cho
Korean Journal of Transplantation.2022; 36(2): 154. CrossRef

Severe Mitral Regurgitation Due to Coronary Vasospasm, Confirmed by Ergonovine Echocardiography.: Jung Joon Cha, Chan Hee Kyung, Jang Ho Cho, Yong Hoon Kim, Haewon Kim, Sung Joo Lee, Se Joong Rim, Eui Young Choi; Yeungnam Univ J Med. 2013;30(2):120-123. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.120

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Abstract PDF: The common causes of organic mitral regurgitation (MR) include mitral valve prolapse (MVP) syndrome, rheumatic heart disease, and endocarditis. MR also occurs secondary to dilated cardiomyopathy and coronary artery disease. In acute severe MR, the hemodynamic overload often cannot be tolerated, and mitral valve repair or replacement must be performed immediately. We report herein a case of severe MR due to coronary vasospasm that was confirmed via ergonovine echocardiography in a 70-year-old man. He was scheduled to undergo mitral valve surgery, but it did not push through and he was put on medical therapy.

A Case of Successful Recovery from High Dose Intravenous Nicorandil Infusion in Refractory Coronary Vasospasm with Hemodynamic Collapse.: Won Jun Koh, Jeong Hyeon Cho, Ji Hyun Lee, Won Sik Kang, Min Kyung Lee, Jun Hyoung Kim, Deok Kyu Cho; Yeungnam Univ J Med. 2012;29(2):129-131. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.129

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Abstract PDF: A 70-year-old male came to the emergency room of the authors' hospital because of sudden cardiac arrest due to inferior wall ST elevation myocardial infarction. His coronary angiography revealed multiple severe coronary spasms in his very long left anterior descending artery. After an injection of intracoronary nitroglycerine, his stenosis improved. The cardiac arrest relapsed, however, accompanied by ST elevation of the inferior leads, while the patient was on diltiazem and nitrate medication to prevent coronary spasm. Recovery was not achieved even with cardiac massage, intravenous injection of epinephrine and atropine, and intravenous infusion of nitroglycerine. The patient eventually recovered through high-dose nicorandil intravenous infusion without ST elevation of his inferior leads. Therefore, intravenous infusion of a high dose of nicorandil must be considered a treatment option for cardiac arrest caused by refractory coronary vasospasm.

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