J Lipid Atheroscler.  2015 Dec;4(2):145-148. 10.12997/jla.2015.4.2.145.

A Case of Non ST Elevation Myocardial Infarction by Coronary Artery Focal Spasm in a Patient with Autosomal Dominant Polycystic Kidney Disease

• Lee DW
• Pyeon SI
• Oh KJ
• Park HJ
• Chae CB
• Choi JH
• Kim JH

• KMID: 2151824
• DOI: http://doi.org/10.12997/jla.2015.4.2.145

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. The main causes of death in ADPKD are cardiovascular disease as well as infections and neurological reasons. ADPKD is causing vasculopathy including aortic root dilation, cerebral artery aneurysm, coronary aneurysm, and aortic dissection. In this case report, we describe a 37-year-old female ADPKD patient with non-ST elevation MI (NSTEMI) caused by coronary artery focal spasm.

Keyword

Autosomal dominant polycystic kidney disease; Non-ST Elevation MI; Coronary artery focal spasm

MeSH Terms

Adult
Aneurysm
Cardiovascular Diseases
Cause of Death
Cerebral Arteries
Coronary Aneurysm
Coronary Vessels*
Female
Humans
Myocardial Infarction*
Polycystic Kidney, Autosomal Dominant*
Spasm*

Figure

• 

  Fig. 1 Computed-tomography (CT) scans during the first visit. CT shows that both kidneys have polycystics. (A) Horizontal view, (B) Coronal view.

• 

  Fig. 2 Echocardiography during the first visit. Apical four-chamber view shows apical Regional wall motion abnormality (RWMA) (A) and apical RWMA with ballooning (B).

• 

  Fig. 3 Coronary angiography shows 70-80% stenosis in the mid left anterior descending coronary artery.

• 

  Fig. 4 Intravascular ultrasound. (A) Before injection of nitroglycerin in patient with coronary artery. External elastic membrane (EEM) cross-sectional area (CSA): 4.7 mm2, lumen CSA: 3.7 mm2, 21% stenosis (plaque area/EEM CSA), (B) After injection of nitroglycerin in patient with coronary artery. EEM CSA: 7.15mm2, lumen CSA: 4.76mm2, 33% stenosis.

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