抄録
We report a case of stunned myocardium induced by coronary vasospasm which was associated with spontaneous pneumothorax. A 72-year-old woman with a sudden onset of chest pain was transferred to our hospital by an ambulance. Electrocardiography on admission suggested evidence of myocardial ischemia, and chest radiography disclosed a right pneumothorax. After right chest drainage was carried out, the findings of myocardial ischemia on electrocardiography persisted. Therefore, emergency coronary angiography was performed, which demonstrated coronary vasospasm on an acetylcholine loading test. Left ventriculography revealed akinesis in a portion of the anterior wall that normalized on echocardiography two days later. We made a diagnosis of stunned myocardium associated with pneumothorax. The severe chest pain and respiratory alkalosis were conseqences of the coronary vasospasm. It is known that the electrocardiographic characteristics of pneumothorax are similar to those of myocardial ischemia. In patients with pneumothorax and ST-T changes on electrocardiography, coronary vasospasm should be considered.
