Simultaneous Multivessel Coronary Spasm Causing Acute Myocardial Infarction

Abstract

Spontaneous simultaneous multivessel coronary artery spasm in patients with acute myocardial infarction (AMI) is uncommon. A 79-year-old Japanese man was transferred to this hospital because of severe prolonged chest pain and faintness. Left coronary angiography revealed total occlusion of the left anterior descending and the left circumflex coronary arteries. Moreover, right coronary angiography revealed 99% stenosis of the right coronary artery. After intracoronary administration of nicorandil, left coronary artery and right coronary artery angiography revealed no organic stenosis or thrombus. This is the first report in which simultaneous 3-vessel spasm was documented by emergency angiography in AMI.

Nicorandil Attenuates FeCl3-Induced Thrombus Formation Through the Inhibition of Reactive Oxygen Species Production

“…In clinical studies, nicorandil has had beneficial effects on the vascular system, such as prevention of the no-reflow phenomenon, 11-13 a coronary spasmolytic effect [22][23][24] and improvement of microvascular function. 3,4,23 In addition, nicorandil is reported to have a vasodilator action.…”

Acute Simultaneous Proximal Occlusion of Two Major Coronary Arteries in Acute Myocardial Infarction: Successful Treatment with Percutaneous Coronary Intervention

“…Some authors postulate that vasospasm is a major cause of AMI due to ASOMC. 15,16 In our ASOMC patients, spontaneous vasospasm was not observed during CA in any patient.…”

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

“…However, global ischemia induced by simultaneous multiple coronary artery spasm, with clinical presentation of cardiogenic shock, has been rarely reported. Only recently was such a case published for the first time in the English-language literature 9). To our knowledge, a case has never been reported in Korea.…”