Abstract

GALEANO-RICANO, Héctor Alejandro. Dynamic coronary spasm: New entity or presence of an old problem?. Rev. Mex. Cardiol [online]. 2012, vol.23, n.1, pp.20-26. ISSN 0188-2198.

The fact is that percutaneus transluminal coronary angioplasty (ACTP) and implants of stent induce vascular endothelial dysfunction. So severe that it is pronounced by persistent coronary vasoconstriction, conditioning ischemic complications (clinical, electrical and/or enzymatic). Nevertheless, it is possible that it is pronounced of another form: dynamic coronary vasospasm . We present two cases with several similarities: adverse outcome with suspicion of occlusion of stent; interventionism with endothelial aggression (intracoronary ultrasound and implant of stent); and angiographic image of dynamic coronary spasm, confused with muscular bridge. The dynamic coronary spasm can be defined as the dynamic occlusive vasoconstriction, of a epicardial coronary segment, in an artery that it has been put under interventionism. It would have to differentiate it from the no-reflow, caused by the total occlusion of the artery and persistent spasm induced by catheter. In both cases it was reported like muscular bridge, nevertheless, in the study diagnosis was not observed this image. Reason for the present work is to call the attention to the medical community, specifically to the interventionist doctor, on an image that can have a therapeutic and prognosis interest (treatment with calcium antagonists and nitrates, use of cardiac enzyme leves, and closer follow-up), in the evolution of the patient put under coronary interventionism.

Keywords : Coronary angioplasty; stent; dynamic coronary spasm; muscular bridge.

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