Research Reports in Clinical Cardiology (Jun 2025)

Simultaneous Multivessel Coronary Artery Spasm Leading to Acute Myocardial Infarction: A Case Report

  • Ahmed SA,
  • Aden AS,
  • Hassan MO,
  • Abdi IA,
  • Waberi MM,
  • Abdi AE,
  • Mohamud MA,
  • Hassan Fujeyra AM,
  • Ali AA,
  • Ahmed MA,
  • Adam BA,
  • Hassan MS,
  • Aksu F,
  • Dahir OF

Journal volume & issue
Vol. Volume 16, no. Issue 1
pp. 15 – 19

Abstract

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Said Abdirahman Ahmed,1 Ahmed Shafie Aden,1 Mohamed Omar Hassan,1 Ishak Ahmed Abdi,1 Mohamud Mire Waberi,1 Ahmed Elmi Abdi,1 Mohamed Abdullahi Mohamud,2 Abdullahi Mohamed Hassan Fujeyra,3 Abdijalil Abdullahi Ali,4 Mohammed AM Ahmed,5,6 Bakar Ali Adam,7 Mohamed Sheikh Hassan,7 Feyza Aksu,8 Osman Farah Dahir1 1Department of Cardiology, Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia; 2Department of Cardiology, Jazeera Specialist Hospital, Mogadishu, Somalia; 3Dean College of Medicine and Health Science, Abrar University, Mogadishu, Somalia; 4Cardiovascular Surgery Department, Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia; 5Faculty of Medicine, Mogadishu University, Mogadishu, Somalia; 6Department of Pediatric cardiology, Mogadishu Heart Center, Mogadishu, Somalia; 7Neurology Department, Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia; 8Department of Cardiology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, TürkiyeCorrespondence: Osman Farah Dahir, Mogadishu Somalia Turkish Training and Research Hospital, Digfer Road, Mogadishu, Somalia, Tel +252615963164, Email [email protected]: Coronary artery spasm (CAS) refers to a sudden and intense narrowing of the coronary arteries caused by vasoconstriction, which can result in myocardial ischemia and potentially lead to acute myocardial infarction (AMI), even in individuals without significant atherosclerotic risk factors. Simultaneous multivessel coronary spasm is a rare clinical presentation that poses significant diagnostic and therapeutic challenges, with the potential for life-threatening complications.Case Report: We report a case of a 42-year-old male with no history of hypertension, diabetes, or dyslipidemia who presented with sudden-onset retrosternal chest pain radiating to the left arm and jaw, associated with diaphoresis. The electrocardiography (ECG) demonstrated ST-segment elevation in the inferior leads with reciprocal changes, while cardiac biomarkers confirmed myocardial injury. Urgent coronary angiography revealed diffuse spasm in both the right coronary artery and obtuse marginal artery without significant atherosclerotic lesions, which resolved after intracoronary nitrate administration. Management included sublingual nitroglycerin, calcium channel blockers, and lifestyle modifications. The patient remained thermodynamically stable during hospitalization, with no recurrence of symptoms.Conclusion: Simultaneous multivessel CAS is a rare but important cause of AMI, particularly in younger patients without typical risk factors. Early diagnosis and treatment are key, and this case underscores the need for greater awareness and research into its management.Keywords: coronary vasospasm, coronary arteries, ECG, calcium channel blockers, vasodilators

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