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JAMA Cardiology Clinical Challenge
August 14, 2019

A Young Woman With Refractory Vasospastic Angina

Author Affiliations
  • 1Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
JAMA Cardiol. Published online August 14, 2019. doi:10.1001/jamacardio.2019.1667

A woman in her early 30s with a history of mild bronchial asthma and nasal polyps presented to the emergency department with chest pain, electrocardiographic ST elevation, and sudden cardiac arrest. Cardiopulmonary resuscitation was initiated and was followed with coronary angiography, which showed significant 3-vessel stenosis that completely resolved after nitroglycerin injection. The patient was diagnosed as having vasospastic angina (VA); diltiazem and glyceryl trinitrate were prescribed, and an implantable cardioverter-defibrillator (ICD) was implanted.