SPONTANEOUS CORONARY-ARTERY SPASM DOCUMENTED IN A YOUNG WOMAN - A CASE-REPORT

A 29-year-old woman with coronary risk factors presented with nonexert ional atypical burning chest pain of 1 week's duration. A myocardial p erfusion study with Tc-99m MIBI revealed a severe stress induced anter oseptal perfusion defect that completely reperfused on a subsequent re sting Tc-99m MIBI study. Coronary angiography showed mild nonobstructi ve coronary artery disease. At the termination of the procedure, a spo ntaneous episode of burning chest pain occurred. Left main coronary ar tery reinjection of contrast revealed proximal diffuse left anterior d escending coronary artery spasm. The patient was followed for 2 years with no further episodes of chest pain, while on calcium channel-block er medication. The phenomenon of vasospastic angina and the role of my ocardial perfusion scintigraphy is discussed.