Abstract
A 65-year-old woman was admitted with severe but mainly atypical chest pain at rest for some weeks. Two years ago, primary percutaneous coronary intervention with stenting of the mid left anterior descending artery (LAD) had been performed in the setting of an anterior myocardial infarction. Physical examination, electrocardiogram, serum levels of troponin I, and echocardiography were normal. During maximal treadmill test, a significant depression of the ST segment was found in leads V4 to V6 while the patient remained asymptomatic. Coronary angiography demonstrated normal right (figure 1A) and circumflex (figure 1B) coronary arteries while the LAD was totally occluded just proximal to the previously implanted stent (figure 1B). However, a few minutes later, ventriculography showed – besides normal left ventricular function – anterograde filling of the LAD (figure 1C, arrows).
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Department of Cardiology, Medisch Spectrum Twente, Enschede, the Netherlands
Department of Cardiology, Medisch Spectrum Twente, Enschede, and Institute for Biomedical Technology (BMTI), University of Twente, the Netherlands
Correspondence to : C. von Birgelen Department of Cardiology, Thoraxcenter Twente, Medical Spectrum Twente, PO Box 50 000, 7500 KA Enschede, the Netherlands
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Kraaier, K., Hartmann, M., Stoel, M.G. et al. Intermittent spastic coronary occlusion at site of non-significant atherosclerotic lesion requiring stent implantation. NHJL 16, 390–391 (2008). https://doi.org/10.1007/BF03086185
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DOI: https://doi.org/10.1007/BF03086185