Intracoronary Administration of Nicorandil for the Treatment of Spontaneous Microvascular Spasm With ST Segment Elevation

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A 64-year-old man with a history of previous coronary intervention of the left anterior descending artery was admitted to hospital because of recurrent chest pain at rest. Coronary angiography revealed no significant coronary artery stenosis. During preparation for the second shot of the right coronary artery, chest pain occurred unexpectedly, represented by ST segment elevation in leads II, III and aV_F. Immediate right coronary angiography revealed no significant coronary artery stenosis, but markedly delayed contrast medium washout. Intracoronary administration of nicorandil attenuated this phenomenon, and the patient was diagnosed as having angina pectoris caused by microvascular spasm with ST segment elevation. (Circ J 2004; 68: 267 - 269)