Korean Circ J.  2000 Nov;30(11):1455-1459. 10.4070/kcj.2000.30.11.1455.

A Case of Myocardial Infarction caused by a Variant Angina during Treatment with beta-blocker of Intramural Hematoma

• Kim JS
• Kim BK
• Ko YK

• KMID: 2093779
• DOI: http://doi.org/10.4070/kcj.2000.30.11.1455

Abstract

Variant angina is characterized by repeated attack at rest associated with ST-segment elevation on ECG and caused by the spasm of coronary artery. But, the pathogenesis of spasm is not well known. A 44-year old man was transferred for the management of intramural hematoma at descending thoracic aorta and uncontrolled hypertension. We started to control hypertension with nitroprusside, propranolol, amlodipine, and doxazocin. At 4th hospital day, severe chest pain, dizziness, and diaphoresis were developed, and ECG showed not only ST-segment elevation on lead II, III, aVF but also 2 degree AV block(Mobitz type II). CK-MB revealed 52.3 ng/dl. When coronary angiography performed emergently, it showed total occlusion of right coronary artery (RCA) and diffuse minimal narrowing of left anterior descending coronary artery (LAD). After nitroglycerin was infused via right coronary catheter, the RCA was opened completely, and reperfusion arrhythmia was developed. Medication were changed to nifedipine, diltiazem, nicorandil, isosorbide mononitrate and he had no more chest pain.

MeSH Terms

Adult
Amlodipine
Aorta, Thoracic
Arrhythmias, Cardiac
Catheters
Chest Pain
Coronary Angiography
Coronary Vessels
Diltiazem
Dizziness
Electrocardiography
Hematoma*
Humans
Hypertension
Isosorbide
Myocardial Infarction*
Nicorandil
Nifedipine
Nitroglycerin
Nitroprusside
Propranolol
Reperfusion
Spasm
Amlodipine
Diltiazem
Isosorbide
Nicorandil
Nifedipine
Nitroglycerin
Nitroprusside
Propranolol