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Yasushi Koiwaya, MD; Tadashi Ishikawa, MD; Susumu Nakagawa, MD; Hideyuki Ochiai, MD; Kenjiro Tanaka, MD

Arch Intern Med. 1985;145(5):943-945.

Abstract
• A 55-year-old man developed acute inferior myocardial infarction. A coronary arteriogram performed within two hours later showed complete occlusion of the right coronary artery, which was not resolved by two doses of 300 µg of intracoronary nitroglycerin. It was recanalized with 50% luminal diameter narrowing after 600,000 units of urokinase. Immediately after this thrombolytic therapy, the patient experienced chest pain, and the coronary artery became completely obstructed again. The pain was promptly relieved by 300 µg of intracoronary nitroglycerin, with disappearance of the obstruction. The observations during the procedure indicate that coronary artery spasm can occur after successful thrombolytic therapy on an occluded artery, inducing postinfarction angina, and might culminate in a second complete occlusion after percutaneous transluminal coronary recanalization.

(Arch Intern Med 1985;145:943-945)

Author Affiliations
From the First Department of Internal Medicine, Miyazaki (Japan) Medical College.

Footnotes
Accepted for publication Aug 8, 1984.

Read in part before the 55th Kyushu Regional Meeting, Japanese Circulation Society, Oita, Japan, Dec 17, 1983.

Reprint requests to First Department of Internal Medicine, Miyazaki Medical College, 5200 Kihara, Kiyotake, Miyazaki 889-16, Japan (Dr Koiwaya).

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