A CASE OF REST ANGINA DUE TO MICROVASCULAR SPASM

A 66-year-old woman underwent elective cardiac catheterization for inv estigation of periodic attacks of chest pain at rest. During the exami nation, a chest pain attack occurred unexpectedly, resulting in ST ele vation in the precordial leads on electrocardiography. Immediate coron ary arteriography demonstrated no organic stenosis but markedly delaye d contrast medium perfusion in the mid to distal portion of the left a nterior descending artery. These phenomena spontaneously disappeared a bout 3 min later, and the patient was diagnosed as having angina pecto ris due to microvascular spasm. The demonstration of angina pectoris d ue to microvascular spasm by coronary arteriography during a spontaneo us attack is very rare.