Multivessel coronary artery vasospasm masquerading as surgical coronary atherosclerotic disease.
J Card Surg
; 36(10): 3952-3954, 2021 Oct.
Article
in En
| MEDLINE
| ID: mdl-34310756
ABSTRACT
BACKGROUND AND AIM:
We report a case of a 39-year-old lady presenting with worsening angina. MATERIALS ANDMETHODS:
This is a case report study. Clinical case data was retrieved from hospital paper and electronic records.RESULTS:
Invasive coronary angiography revealed disease in the left main stem, proximal left anterior descending (LAD) artery and circumflex artery. The patient proceeded to on-pump coronary artery bypass grafting. Intraoperatively, there were multiple unsuccessful attempts to wean off cardiopulmonary bypass. An on-table angiogram-which initially triggered asystole requiring internal cardiac massage and institution of venoarterial extracorporeal membrane oxygenation (ECMO)- showed no native coronary artery disease. Instead, this angiogram revealed severe vasospasm with narrowing in the grafts and distal LAD. The patient received calcium channel blockers and bilateral thoracic sympathectomies to suppress any further coronary vasospasm. She was subsequently successfully weaned off ECMO. DISCUSSION ANDCONCLUSION:
This case reveals the life-threatening nature and diagnostic dilemma posed by severe multivessel coronary vasospasm. We also highlight the novel role of thoracic sympathectomy for definitive management of refractory vasospastic angina.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Coronary Vasospasm
Type of study:
Diagnostic_studies
Limits:
Adult
/
Female
/
Humans
Language:
En
Journal:
J Card Surg
Journal subject:
CARDIOLOGIA
Year:
2021
Document type:
Article
Affiliation country:
New Zealand