A Case of Non ST Elevation Myocardial Infarction by Coronary Artery Focal Spasm in a Patient with Autosomal Dominant Polycystic Kidney Disease

Dong Wook Lee; Sung Ik Pyeon; Kong Jin Oh; Ho Joon Park; Chul Byung Chae; Jae Hoon Choi; Jin Hee Kim

doi:10.12997/jla.2015.4.2.145

Journal List > J Lipid Atheroscler > v.4(2) > 1059557

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Lee, Pyeon, Oh, Park, Chae, Choi, and Kim: A Case of Non ST Elevation Myocardial Infarction by Coronary Artery Focal Spasm in a Patient with Autosomal Dominant Polycystic Kidney Disease

Case Report

Journal of Lipid and Atherosclerosis 2015; 4(2): 145-148.

Published online: 31 December 2015

DOI: https://doi.org/10.12997/jla.2015.4.2.145

A Case of Non ST Elevation Myocardial Infarction by Coronary Artery Focal Spasm in a Patient with Autosomal Dominant Polycystic Kidney Disease

Dong Wook Lee, Sung Ik Pyeon, Kong Jin Oh, Ho Joon Park, Chul Byung Chae, Jae Hoon Choi, Jin Hee Kim

Department of Internal Medicine, Busan Medical Center, Busan, Korea.

Corresponding Author: Jin Hee Kim, Division of Cardiology, Department of Internal Medicine, Busan Medical Center, Geoje 2-dong, Yeonje-gu, Busan 611-072, Korea. Tel: +82-51-507-3000, yoplait83@hanmail.net

Received 7 September 2015 Revised 12 October 2015 Accepted 20 October 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. The main causes of death in ADPKD are cardiovascular disease as well as infections and neurological reasons. ADPKD is causing vasculopathy including aortic root dilation, cerebral artery aneurysm, coronary aneurysm, and aortic dissection. In this case report, we describe a 37-year-old female ADPKD patient with non-ST elevation MI (NSTEMI) caused by coronary artery focal spasm.

Keywords: Autosomal dominant polycystic kidney disease, Non-ST Elevation MI, Coronary artery focal spasm

Figures and Tables

Fig. 1

Computed-tomography (CT) scans during the first visit. CT shows that both kidneys have polycystics. (A) Horizontal view, (B) Coronal view.

Fig. 2

Echocardiography during the first visit. Apical four-chamber view shows apical Regional wall motion abnormality (RWMA) (A) and apical RWMA with ballooning (B).

Fig. 3

Coronary angiography shows 70-80% stenosis in the mid left anterior descending coronary artery.

Fig. 4

Intravascular ultrasound. (A) Before injection of nitroglycerin in patient with coronary artery. External elastic membrane (EEM) cross-sectional area (CSA): 4.7 mm², lumen CSA: 3.7 mm², 21% stenosis (plaque area/EEM CSA), (B) After injection of nitroglycerin in patient with coronary artery. EEM CSA: 7.15mm², lumen CSA: 4.76mm², 33% stenosis.

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