Severe coronary artery spasm and subsequent coronary subclavian steal syndrome.

摘要

A 57-year-old lady first presented with chest pain at rest lasting for 1 h in 2000. Her background history included hypertension, hypercholesterolaemia, peripheral vascular disease and heavy smoking. There was anterior T-wave inversion on the EGG. Due to the ongoing chest pain and EGG changes, she was transferred to a tertiary cardiac centre where coronary angiography showed a severe ostial left anterior descending (LAD) stenosis with unobstructed left main stem artery (LMS), left circumflex (LCX) (Fig. 1) and right coronary arteries (RCA). She underwent an urgent off-pump coronary artery bypass graft (GABG) with a left internal mammary artery (LIMA) to LAD. She was pain-free and was discharged after a few days. In 2.003, she underwent- uneventful bilateral common iliac angioplasties and subsequently required aortobifemoral bypass in 2004.