Resistant spontaneous coronary artery spasm

Coronary artery spasm should always be suspected in patients who have myocardial infarction with normal coronary arteries. This case report presents a 33-yearold woman with anterior myocardial infarction, whose coronary angiograph revealed normal left anterior descending artery and new onset complete occlusion of the circumflex artery at the time of the procedure. Nitroglycerin up to 800 mcg was administered without success. In such resistant cases, when all efforts fail, including prompt recognition and application of vasodilator drugs, retracting the catheter and waiting may play a role.