References
  1. Rivero F, Antuña P, Cuesta J, Alfonso F. Severe coronary spasm in a COVID-19 patient [published online ahead of print, 2020 Aug 1].Catheter Cardiovasc Interv. 2020;10.1002/ccd.29056. doi:10.1002/ccd.29056
  2. Bangalore S, Sharma A, Slotwiner A, et al. ST‐segment elevation in patients with Covid‐19 – a case series. N Engl J Med. 2020;382(25):2478‐2480
  3. Kounis NG: Kounis syndrome (allergic angina and allergic myocardial infarction): a natural paradigm? Int J Cardiol 2006;110:7-14.
  4. Freeman LJ, Nixon PGF. Chest pain and the hyperventilation syndrome-some etiologic considerations. Postgrad Med J 1985;61:957-61.
  5. Chu G, Zhang G, Zhang Z, Liu S, Wen Q, Sun B: Clinical Outcome of Coronary Stenting in Patients with Variant Angina Refractory to Medical Treatment: A Consecutive Single-Center Analysis. Med Princ Pract 2013;22:583-587. doi: 10.1159/000354290
  6. Tavazzi G, Pellegrini C, Maurelli M, et al. Myocardial localization of coronavirus in COVID‐19 cardiogenic shock. Eur J Heart Fail. 2020;22(5):911‐915
  7. Guo T., Fan Y., Chen M. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (covid-19) JAMA Cardiol. 2020
  8. Meune C, Joly LM, Chiche JD, et al. Diagnosis and management of out-of-hospital cardiac arrest secondary to coronary artery spasm.Resuscitation. 2003;58(2):145-152. doi:10.1016/s0300-9572(03)00149-7
Figure 1. Electrocardiogram (ECG) showing ST elevation >0.1 mV in leads V2 through V6, suggesting ST-segment elevation myocardial infarction.
Figure 2. Left heart catheterization pre intracoronary nitroglycerin injection illustrating multiple stenotic lesions in the left anterior descending artery suspected as coronary vasospasms.
LAD - Left anterior descending artery
Figure 3. Left heart catheterization post intracoronary nitroglycerin injection and resolution of the stenotic lesions in the left anterior descending artery.
LAD - Left anterior descending artery
Figure 4. Intravascular ultrasound of the left anterior descending coronary artery without signs of atherosclerotic significant disease or lesions.