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Trillos D, Krajcer Z, Lufschanowski R, et al. Recurrent myocardial infarction in a patient with Prinzmetal's angina and normal coronary arteries. Cardiovasc Dis. 1980;7(1):95-103
Trillos, D., Krajcer, Z., Lufschanowski, R., Leachman, R. D., Klima, T., & Cooley, D. A. (1980). Recurrent myocardial infarction in a patient with Prinzmetal's angina and normal coronary arteries. Cardiovascular diseases, 7(1), 95-103.
Trillos, Donaldo, et al. "Recurrent myocardial infarction in a patient with Prinzmetal's angina and normal coronary arteries." Cardiovascular diseases vol. 7,1 (1980): 95-103.
Trillos D, Krajcer Z, Lufschanowski R, Leachman RD, Klima T, Cooley DA. Recurrent myocardial infarction in a patient with Prinzmetal's angina and normal coronary arteries. Cardiovasc Dis. 1980 Mar;7(1):95-103. PMID: 15216288; PMCID: PMC287838.
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Cardiovasc Dis. 1980 Mar;7(1):95-103.

Recurrent myocardial infarction in a patient with Prinzmetal's angina and normal coronary arteries.

Cardiovascular diseases

Donaldo Trillos, Zvonimir Krajcer, Roberto Lufschanowski, Robert D. Leachman, Tomas Klima, Denton A. Cooley

Affiliations

  1. Divisions of Cardiology, Pathology and Surgery of St. Luke's Episcopal Hospital and the Texas Heart Institute, Houston, Texas.

PMID: 15216288 PMCID: PMC287838

Abstract

A 55-year-old man was referred for the evaluation of frequent chest pain and syncope. While in the hospital, he experienced severe chest pain accompanied by transient ST segment elevation and a slight elevation of cardiac enzyme levels. Multiple coronary arteriograms were recorded at various times during an interval of 2 months. On one occasion, the results were normal; on another occasion, they showed total occlusion of the left anterior descending, diagonal, and circumflex coronary arteries. The occlusion was completely relieved with sublingual nitroglycerin. Because the patient's clinical condition deteriorated rapidly, double aortocoronary saphenous vein bypass was performed to the left anterior descending and circumflex coronary arteries. During the induction of anesthesia, ventricular fibrillation occurred, and the patient died from refractory recurrent fibrillation 4 hours after surgery. Postmortem examination revealed normal coronary arteries, patent vein grafts, and multiple focal areas of recent and old myocardial fibrosis. Thus, it appears that coronary spasm, in the presence of otherwise normal coronary arteries, can produce myocardial infarction with necrosis, and that medical management may provide a more successful method of treating such patients.

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