Management of thrombotic events secondary to cardiac interventions - Severe, resistant spasm of the left main coronary artery - A serious pitfall

A case of severe, resistant spasm of the left main coronary artery, which w as not relieved even after 600 micrograms of intracoronary nitroglycerine o ver 30 minutes, is described. The case was mistakenly taken for fixed steno sis and would have been subjected to percutaneous transluminal coronary ang ioplasty with stenting at the same sitting, had not the case been fortuitou sly deferred. On repeat angiography after one week, the left main was found to be normal. Some guidelines to avoid such a situation are suggested.