Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Variant Angina Associated with Coronary Artery Endothelial Dysfunction and Myocardial Bridge: A Case Report and Review of the Literature
Federico NardiEdoardo VernaGioel Gabrio SeccoAndrea RognoniAngelo Sante BongoGabriele IraghiStefano BertuolAlessandro Lupi
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JOURNALS OPEN ACCESS

2011 Volume 50 Issue 21 Pages 2601-2606

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Abstract

The association of variant angina (VA) and myocardial bridges is a rare finding. We describe a case of VA with recurrent coronary spasm triggered by different stimuli at the site of a myocardial bridge. The interplay of endothelial dysfunction, coronary vasoconstriction and myocardial bridging was detected by intracoronary acetylcholine test and IVUS. We speculate that mechanical stimulation at the bridge site caused endothelial dysfunction and enhanced local susceptibility to vasoconstrictor stimuli. Variant angina should always be suspected in cases of ST-elevation acute coronary syndrome without any significant angiographic coronary stenosis.

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© 2011 by The Japanese Society of Internal Medicine
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