Multivessel Vasospastik Angina with ST Segment Elevation and Total AV Block

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.

Keywords

• akut miyokardial enfarktüs
• koroner anjiyografi
• koroner arter hastalığı
• acute myocardial infarction
• coronary angiography
• coronary artery disease