Reversible ischemia on treadmill exercise in left main coronary artery vasospasm

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Abstract

Coronary vasospasm of the left main coronary artery (LMCA) is a rare condition with potentially devastating consequences. We present 2 patients with LMCA vasospasm-related angina, the first being a 46-year-old woman and the second a 51-year-old woman. Both of them developed ST-segment ischemic changes on treadmill exercise tests. Coronary angiography showed spontaneous LMCA vasospasm in one patient and methylergonovine-induced LMCA vasospasm in the other patient. Follow-up treadmill exercise tests revealed no exercise-induced ischemia after calcium antagonist monotherapy. These cases demonstrate the importance of identifying LMCA vasospasm, as the treatment of choice varies in patients with angina pectoris. Reversible myocardial ischemia caused by LMCA vasospastic angina can be controlled by calcium antagonist monotherapy and detected by repeat non-invasive stress testing.

Original languageEnglish
Pages (from-to)4364-4367
Number of pages4
JournalChinese Medical Journal
Volume124
Issue number24
DOIs
Publication statusPublished - Dec 20 2011

Keywords

  • Coronary vasospasm
  • Ischemia
  • Left main coronary artery
  • Treadmill

ASJC Scopus subject areas

  • Medicine(all)

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