Images in Clinical Medicine
Kim Eagle, M.D., Editor
Acute Myocardial Infarction and Coronary Spasm
N Engl J Med 1994; 330:1420May 19, 1994
- Article
Figure 1 Acute Myocardial Infarction and Coronary Spasm.
A 41-year-old woman with a history of hypertension and cigarette smoking was admitted to the emergency department with chest pain. Electrocardiography revealed changes consistent with acute anterior myocardial infarction. Recurrent ventricular fibrillation required several electric cardioversions. At coronary angiography, spontaneous spasm of the proximal left anterior descending artery (white arrows) was evident (Panel A), as was mild catheter-induced spasm of a portion of the left main coronary artery (black arrow). Intracoronary nitroglycerin reversed the coronary spasm (Panel B). The patient was treated with nitrates and a calcium-channel blocker. Two weeks after admission she died suddenly.
Kim Eagle, M.D.
Ik-Kyung Jang, M.D., Ph.D.
Massachusetts General Hospital, Boston, MA 02114
