Multi-vessel coronary artery spasm

A 69-year-old male, a chronic smoker with history of hypertension, presented with chest pain. Electrocardiogram showed marked ST-depression over antero-lateral leads (Panel A). Echocardiogram showed inferior wall hypokinesia. Troponin level was elevated confirming the diagnosis of non-ST-elevation myocardial infarction. He was treated with aspirin, clopidrogel, low molecular heparin, and glycoprotein 2b/3a inhibitors. Coronary angiography the following day (Panel C) showed non-obstructive diffusely diseased vessels over …