ST-elevation myocardial infarction secondary to coronary artery spasm provoked by food

William Young

Rai Bhichhyan

Alamgir Kabir

Wajid Hussain

^{Department of Cardiology, NHS, London, UK}

^{Royal Gwent Hospital, Newport, UK}

^{Basildon Hospital, Basildon, UK}

^{Department of Cardiology, Royal Brompton Hospital, London, UK}

^{Dr William Young,}ten.shn@1gnuoymailliw

Accepted 2014 Aug 25.

Abstract

We describe a patient with recurrent episodes of inferior ST elevation, secondary to coronary artery spasm. Each episode appeared to be provoked by the ingestion of rice and accompanied by a troponin T rise. An inpatient coronary angiogram immediately following an episode of pain demonstrated a focal area of spasm affecting the right coronary artery, which resolved with intracoronary nitrate injection. Although these episodes were self-limiting, cardiac MRI confirmed an acute subendocardial infarct. An association between food substances and coronary artery spasm with subsequent infarction has not been documented previously. Following appropriate advice and titration of antispasmodic medication, the patient has been pain free.

Abstract

Learning points

Footnotes

Contributors: WY wrote the discussion and case history. RB assisted with writing the case history. AK performed the coronary angiogram, reviewed the manuscript and gave advice regarding its contents. WH reviewed the manuscript and gave advice regarding its contents.

Competing interests: None.

Patient consent: Obtained.

Provenance and peer review: Not commissioned; externally peer reviewed.

Footnotes

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