Case Sharing: A Case of Coronary Spasmodic Angina Pectoris Resulting in Myocardial Infarction due to Idiopathic Coronary Artery Dissection
Dr. Masaki Kono, Kouseikai Hospital
Case Example
Female in her 50s
Medical and life history
No special note
Family history
Mother: hypertension, heart disease
Father: diabetes
Current medical history
On July Y, 20XX, she visited her local doctor with a chief complaint of presyncope. 12-lead ECG showed ST depression at I aVL V5 6 and flat low T wave at III aVF, but she went home that day.
Later that day, she returned to the same hospital because of chest pain in the morning. The 12-lead ECG showed ST-segment elevation in II Ⅲ aVF, ST depression in I aVL, and negative T waves in V2 to 6.
A 12-lead EKG at the time of the visit showed a flat low T wave in II, mild ST elevation in III aVF, ST depression in I aVL V4-6, and negative T wave. Blood tests showed a mildly elevated level of myocardial desensitization enzymes, and acute myocardial infarction was suspected, and the patient was admitted to our department for close examination and treatment.
Present condition on admission
Blood pressure 131/92mmHg, heart rate 63/min
Body temperature was 36.8°C, SpO2 was 98% (room air)
No heart murmur, no rales, no edema of the lower legs
Vitals were normal, and no abnormal findings were noted on physical examination.
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