Acute coronary syndrome as the first symptom of vasospastic angina – case report of a 38-year-old man with myocardial infarction with non-obstructive coronary artery disease

Łukasz Gabryel; Klaudyna Bugla; Tomasz Pawłowski; Aneta Gziut-Rudkowska

doi:10.18794/aams/190767

2024 vol. 78

Acute coronary syndrome as the first symptom of vasospastic angina – case report of a 38-year-old man with myocardial infarction with non-obstructive coronary artery disease

Łukasz Gabryel ¹

Klaudyna Bugla ¹

Tomasz Pawłowski ^1,2

Aneta Gziut-Rudkowska ^1,2

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Department of Cardiology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland

Centre of Postgraduate Medical Education, Warsaw, Poland

Corresponding author

Łukasz Gabryel

Klinika Kardiologii, Państwowy Instytut Medyczny MSWiA, ul. Wołoska 137, 02-507 Warszawa

Ann. Acad. Med. Siles. 2024;78:304-308

DOI: https://doi.org/10.18794/aams/190767

Article (PDF)

References (9)

KEYWORDS

STEMI

coronary artery spasm

TOPICS

Cardiology

ABSTRACT

A 38-year-old obese man with hypertension and a twenty-year history of nicotinism was admitted for a suspected ST-segment elevation myocardial infarction (STEMI). Coronary angiography did not reveal significant coronary artery stenosis, which, together with symptoms of acute coronary syndrome and increased troponin I levels, led to the diagnosis of myocardial infarction with non-obstructive coronary artery disease (MINOCA) and implied a differential diagnosis. Given the clinical picture, a provocative test with acetylcholine was performed, which indicated the vasoconstrictive origin of MINOCA. In order to reduce the likelihood of another episode, pharmacotherapy was changed and lifestyle changes were recommended.

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