Case report: Coronary artery spasm during coronary angiography leading to faulty decision


  • Farhan Umair Punjab Institute of Cardiology, Lahore
  • Hafiz Rashid Ali Punjab Institute of Cardiology, Lahore
  • Ahmad Noeman Punjab Institute of Cardiology, Lahore



CABG, Spasm, Intracoronary nitro glycerine



Coronary artery spasm defined as constriction of coronary artery segment either focal or diffuse, may be single or multiple. Which is reversible and cause myocardial ischemia by restricting coronary blood flow and may lead to thrombus formation. We present a case of coronary artery spasm that lead to CABG and was discovered after CABG.

Author Biographies

Farhan Umair, Punjab Institute of Cardiology, Lahore

Senior Registrar Cardiology

Hafiz Rashid Ali, Punjab Institute of Cardiology, Lahore

Senior Registrar Cardiology

Ahmad Noeman, Punjab Institute of Cardiology, Lahore

Professor of Cardiology 


Takagi Y, Yasuda S, Takahashi J, Tsunoda R, Ogata Y, Seki A, et al. Clinical implications of provocation tests for coronary artery spasm: safety, arrhythmic complications, and prognostic impact: multi centre registry study of the Japanese Coronary Spasm Association. European heart journal. 2013;34(4):258-67.

Gu C, Qiao R. Intracoronary nitroglycerin injection through a homemade side-hole balloon for coronary slow/no-reflow phenomenon prevention. European Heart Journal. 2020;41(Supplement_2):ehaa946. 1267.

Pustjens T, Appelman Y, Damman P, Ten Berg J, Jukema J, de Winter R, et al. Guidelines for the management of myocardial infarction/injury with non-obstructive coronary arteries (MINOCA): a position paper from the Dutch ACS working group. Netherlands Heart Journal. 2020;28(3):116-30.

Kim H-J, Kim M-A, Kim H-L, Park SM, Kim M, Yoon HJ, et al. Differences in clinical characteristics between men and post-menopausal women with chest pain who have normal coronary arteries. CardioMetabolic Syndrome Journal. 2021;1(1):76-84.

Hung M-Y, Kounis NG, Lu M-Y, Hu P. Myocardial Ischemic Syndromes, Heart Failure Syndromes, Electrocardiographic Abnormalities, Arrhythmic Syndromes and Angiographic Diagnosis of Coronary Artery Spasm: Literature Review. International journal of medical sciences. 2020;17(8):1071.

Goettler D, Wagner M, Faller H, Kotseva K, Wood D, Leyh R, et al. Factors associated with smoking cessation in patients with coronary heart disease: a cohort analysis of the German subset of EuroAspire IV survey. BMC cardiovascular disorders. 2020;20:1-9.

Kook H, Hong SJ, Yang K-S, Lee S, Kim J-S, Park CG. Comparison of nebivolol versus diltiazem in improving coronary artery spasm and quality of life in patients with hypertension and vasospastic angina: A prospective, randomized, double-blind pilot study. PloS one. 2020;15(9):e0239039.

Benahmed I, Laachach H, Ismaili N. A young adult presenting with ST elevation myocardial infarction due to a persistent spasm of proximal left descending artery: An image focus.

Okuya Y, Park JY, Garg A, Moussa I. Coronary artery spasm during catheter ablation caused by the intravenous infusion of isoproterenol. Internal Medicine. 2021:6130-20.

Matsumoto Y, Nishimiya K, Ohyama K, Uzuka H, Amamizu H, Takahashi J, et al. Treatment of Coronary Artery Spasm. Coronary Vasomotion Abnormalities: Springer; 2021. p. 59-76.





Case Report