Radiology Case Reports (Feb 2018)

Coronary arterial spasm detected by coronary computed tomography angiography and confirmed by intravascular ultrasound

  • Masafumi Nakayama, MD,
  • Masaharu Hirano, MD,
  • Sonoka Goto, MD,
  • Akifumi Watanabe, MD,
  • Takashi Uchiyama, MD

DOI
https://doi.org/10.1016/j.radcr.2017.09.002
Journal volume & issue
Vol. 13, no. 1
pp. 14 – 17

Abstract

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A 40-year-old man was admitted to our hospital for chest pain after smoking. Coronary computed tomography angiography showed severe stenosis in the left anterior descending artery. The stenosis site had no plaque on stretched curved multiplanar reconstruction and short-axis images. Coronary angiography revealed improvement of the severe stenosis after the intracoronary administration of isosorbide dinitrate in the left anterior descending artery. Intravascular ultrasound demonstrated negative remodeling without a plaque and diffuse intima with media thickening at the stenosis site. The chest pain was likely caused by coronary spastic angina, which was treated with diltiazem hydrochloride.

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