Electrocardiographic Detection of Multiple Exercise-Induced and Spontaneous Coronary Spasms: A Case Report

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Abstract

The incidence of multivessel coronary spasm without fixed obstructive lesions has not been well established. We report the case of a patient with variant angina who presented precordial pain and ST-segment elevation in both anterior and inferior leads during a treadmill stress test. While angiography was being performed, spontaneous angina developed accompanied by ST-segment elevation and spasm of the left anterior descending and right coronary arteries was demonstrated. After nitro- glycerine was administered, coronary arteries proved to be angiographically normal. We wish to emphasize the importance of 12-lead electrocardiographic monitor- ing as a useful method of predicting simultaneous multivessel involvement.