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CASE20191030_033
| CORONARY - Acute Coronary Syndromes (STEMI, NSTE-ACS) | |
| Unstable Angina Pectoris Due to Coronary Artery Spasm: What Is the Effective Treatment? | |
| Muthia Farah Ashma1, Yahya Berkahanto Juwana2, Herawati Isnanijah3, Rido Sukaton4 | |
| Pasar Rebo General Hospital, Indonesia1, Rs Pondok Indah, Indonesia2, Pasar Rebo General Hospital Jakarta, Indonesia3, RSUD Pasar Rebo, Indonesia4, | |
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[Clinical Information]
- Patient initials or identifier number:
AHP
-Relevant clinical history and physical exam:
A 50 years old man presented with unstable angina pectoris and past medical histrory of hipertension. His vitals on presentation to the emergency room were : blood pressure (BP) 170/100 mmHg; heart rate (HR) 90/min; respiratory rate (RR) 24/min; afebrile. His physical exam, including cardiac and pulmonary exams, were unremarkable. Initial electrocardiography (ECG) revealed no ST segment deviation and normal troponin I.
 -Relevant test results prior to catheterization:
The patient with unstable angina pectoris and refractory angina was given oral nitrate in hospital and after discharged, but the angina symptoms not relieved
- Relevant catheterization findings:
Coronary angiography (CAG) showed significant narrowing in mid left anterior descending (LAD), approximately 75% of stenosis and no significant stenosis in other segment. Before coronary intervention we administrated 200 micrograms nitroglycerin (NTG) intracoronary twice in the diagnostic catheter and the LAD gradually becoming to normal size.
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[Interventional Management]
- Procedural step:
CAG was done using femoral approach and cannulation with Performa 6F JR3.5, Performa 6F JL 4.0, Terumo Radifocus Introducer II 6F, Wire 0.0038 and showed significant narrowing in mid LAD, approximately 75% of stenosis and no significant stenosis in other segment. Before coronary intervention we administrated 200 micrograms nitroglycerin intracoronary twice in the diagnostic catheter and the LAD gradually becoming to normal size.
 stenosis narrowing.mp4 after NTG 200.mp4- Case Summary:
Administrated nitroglycerin intracoronary relatively effective in patient unstable angina pectoris due to coronary spasm.
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