Abstract
49
yaşında bayan hasta, elektrokardiyografisinde inferior derivasyonlarda (D2-D3
ve aVF) ST segment elevasyonu ve total atrio-ventriküler blok olması nedeni ile
hastanemize başvurdu. Hastanın koroner yoğun bakımda çekilen
elektrokardiyografisinde ST segment elevasyonlarının gerilediği ve total
atrio-ventriküler bloğun kaybolmuş olduğu görüldü. Hasta geçici ST eleve
myokard enfarktüsü olarak kabul edildi ve koroner anjiyografisi yapıldı.
Koroner anjiyografide sol ana koroner arter (LMCA) ve sağ koroner arterde (RCA)
kritik lezyonlar görüldü. Hastanın durumunun vazospazma bağlı olabileceği
düşünülerek intrakoroner nitrat yapıldı. Vazospazmın yok olduğu ve TIMI-3
akımın tekrar oluştuğu görüldü. Hastanın göğüs ağrısı ortadan kalktı. Hastaya
vazospastik angina tanısı konularak tedavisi başlandı. Hasta taburcu edildi ve
hastanın 1 yıl süresince yapılan takiplerinde göğüs ağrısı tekrarlamadı.
References
- 1. Germing A, Lindstaedt M, Ulrich S, Grewe P, Bojara W, Lawo T, et al. Normal angiogram in acute coronary syndrome- preangiographic risk stratification, angiographic findings and follow-up. Int J Cardiol 2005;99:19-23.
- 2. Mohlenkamp S, Eggebrecht H, Ebralidze T, Munzberger S, Schweizer T, Quast B, et al. Normal coronary angiography with myocardial bridging: a variant possibly relevant for ischemia. Herz 2005;30:37-47. [Abstract]
- 3. Prinzmetal M, Kennamer R, Merliss R, Wada T, Bor N. Angina pectoris. I. A variant form of angina pectoris; preliminary report. Am J Med 1959;27:375-88.
- 4. Sarı C, Çiçek Ö, Baştuğ S, Bayram H, Ertem A, Ayhan H et al. Koroner Anjiyografi Sırasındaki Nitrogliserin Uygulamalarının Lezyonları Değerlendirmedeki Önemi. Sakarya Tıp Dergisi, 2015;5;3:168-171 5. Baek JH, Han SS and Lee DH. Native Coronary Artery and Grafted Artery Spasm Just after Coronary Artery Bypass Grafting: A Case Report. J Korean Med Sci. 2010 Apr;25(4):641-643. 6. Rigatelli G, Rigatelli G, Rossi P, Docali G. Normal angiogram in acute coronary syndromes: the underestimated role of alternative substrates of myocardial ischemia. Int J Cardiovasc Imaging 2004;20:471-5.
- 7. Bertrand ME, Lablanche JM, Tilmant PY, Thieuleux FA. Coronary artery spasm. Apropos of 165 cases. Arch Mal Coeur Vaiss 1983;76:713-21. [Abstract]
- 8.Mancio J, Caerio D, Faria R, Marques M, Bernardino S, Oliveira M et al. A 75-year-old woman with chest pain and transient severe left ventricular systolik dysfunction. Rev port Cardiol. 2015; 34(10): 621.e1-621.e8
- 9. Seltzer CC. Smoking and coronary heart disease: what are we to believe? Am Heart J 1980;100:275-80.
- 10. Porta M, Jick H, Habakangas JA. Follow-up study of pseudoephedrine users. Ann Allergy 1986;57:340-2.
Abstract
A 49-year-old female patient was admitted
to our hospital with ST segment elevation in the inferior derivations (D2, D3,
aVF) and a total atrioventricular block. The initial electrocardiography
performed on the patient in the coronary intensive care unit showed no total AV
block and no ST segment elevation. The patient was accepted as a transient ST segment
elevation MI and a coronary angiogram was performed. The coronary angiogram
showed critical lesions in the left main coronary artery (LMCA) and the right
coronary artery (RCA). We thought that the patient’s condition might have been
caused by vasospasm and gave intracoronary nitroglycerin. Subsequently, we
noticed that the vasospasm disappeared and formed TIMI-3 flow again. The
patient’s chest pain disappeared. The patient’s diagnosis was determined to be
vasospastic angina, and she was given treatment accordingly. The patient was
discharged, and the chest pain did not recur at 1 year follow up.
References
- 1. Germing A, Lindstaedt M, Ulrich S, Grewe P, Bojara W, Lawo T, et al. Normal angiogram in acute coronary syndrome- preangiographic risk stratification, angiographic findings and follow-up. Int J Cardiol 2005;99:19-23.
- 2. Mohlenkamp S, Eggebrecht H, Ebralidze T, Munzberger S, Schweizer T, Quast B, et al. Normal coronary angiography with myocardial bridging: a variant possibly relevant for ischemia. Herz 2005;30:37-47. [Abstract]
- 3. Prinzmetal M, Kennamer R, Merliss R, Wada T, Bor N. Angina pectoris. I. A variant form of angina pectoris; preliminary report. Am J Med 1959;27:375-88.
- 4. Sarı C, Çiçek Ö, Baştuğ S, Bayram H, Ertem A, Ayhan H et al. Koroner Anjiyografi Sırasındaki Nitrogliserin Uygulamalarının Lezyonları Değerlendirmedeki Önemi. Sakarya Tıp Dergisi, 2015;5;3:168-171 5. Baek JH, Han SS and Lee DH. Native Coronary Artery and Grafted Artery Spasm Just after Coronary Artery Bypass Grafting: A Case Report. J Korean Med Sci. 2010 Apr;25(4):641-643. 6. Rigatelli G, Rigatelli G, Rossi P, Docali G. Normal angiogram in acute coronary syndromes: the underestimated role of alternative substrates of myocardial ischemia. Int J Cardiovasc Imaging 2004;20:471-5.
- 7. Bertrand ME, Lablanche JM, Tilmant PY, Thieuleux FA. Coronary artery spasm. Apropos of 165 cases. Arch Mal Coeur Vaiss 1983;76:713-21. [Abstract]
- 8.Mancio J, Caerio D, Faria R, Marques M, Bernardino S, Oliveira M et al. A 75-year-old woman with chest pain and transient severe left ventricular systolik dysfunction. Rev port Cardiol. 2015; 34(10): 621.e1-621.e8
- 9. Seltzer CC. Smoking and coronary heart disease: what are we to believe? Am Heart J 1980;100:275-80.
- 10. Porta M, Jick H, Habakangas JA. Follow-up study of pseudoephedrine users. Ann Allergy 1986;57:340-2.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | June 15, 2020 |
| Submission Date | April 6, 2020 |
| Published in Issue | Year 2020 Volume: 10 Issue: 2 |
The published articles in SMJ are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.