A 43-year-old woman visits the clinic because she has occasionally experienced chest pain during the previous 12 months. She describes the discomfort as a 10-15 minute-long midline pressure or squeezing sensation that occasionally includes perspiration. The patient smokes but has no history of diabetes or high blood pressure. During a nighttime chest pain episode, ambulatory ECG monitoring detects transient ST-segment increases in the anteroseptal leads. Despite the absence of atherosclerotic stenosis on coronary angiography, acetylcholine injection causes identical chest discomfort and ECG abnormalities. Which of the following best explains the coronary intervention findings in this patient?

Question

A 43-year-old woman visits the clinic because she has occasionally experienced chest pain during the previous 12 months. She describes the discomfort as a 10-15 minute-long midline pressure or squeezing sensation that occasionally includes perspiration. The patient smokes but has no history of diabetes or high blood pressure. During a nighttime chest pain episode, ambulatory ECG monitoring detects transient ST-segment increases in the anteroseptal leads. Despite the absence of atherosclerotic stenosis on coronary angiography, acetylcholine injection causes identical chest discomfort and ECG abnormalities. Which of the following best explains the coronary intervention findings in this patient?

Quizplus · Accepted Answer

Eductional Objective: Intermittent coronary vasospasm brought on by endothelial dysfunction and autonomic instability results in vasospastic angina. Acetylcholine ordinarily induces vasodilation, however in patients with the condition, a lack of vasodilatory endothelial nitric oxide causes coronary vasospasm.

A 43-Year-Old Woman Visits the Clinic Because She Has Occasionally