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Case Reports in Medicine
Volume 2010 (2010), Article ID 202156, 4 pages
http://dx.doi.org/10.1155/2010/202156
Case Report

Multifocal Severe Coronary Artery Vasospasm Mistaken for Diffuse Atherosclerosis: A Case Report

1Department of Radiology, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
2Royal Brompton & Harefield NHS Foundation Trust, Hill End Road, Harefield, Middlesex UB9 6JH, UK

Received 2 June 2010; Accepted 4 August 2010

Academic Editor: Hisao Ogawa

Copyright © 2010 Sarfraz Ahmed Nazir et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spontaneous severe multivessel coronary artery vasospasm is a rare but important cause of morbidity. One-third of patients have normal coronary vasculature, and these pose a significant therapeutic dilemma as lack of clinical suspicion might potentially lead to unnecessary revascularization therapies. A patient with resting chest pain and ischaemic electrocardiography demonstrated severe coronary obstruction at catheter angiography. Preangioplasty further information highlighted spasm as the likely cause and the angiographic abnormalities resolved post intracoronary nitrate. This paper emphasises thorough history-taking and judicious use of nitrates during diagnostic coronary angiography in such patients. This may negate the need for more complex cardiac interventions.