Paradoxical coronary vasospasm and transient apical ballooning in a post-menopausal woman: An imaging case report of an unusual INOCA presentation

Madhavi Kadiyala; Saikrishna Patibandla; Erin D Michos

doi:10.1016/j.ahjo.2022.100101

Paradoxical coronary vasospasm and transient apical ballooning in a post-menopausal woman: An imaging case report of an unusual INOCA presentation

Am Heart J Plus. 2022 Feb 14:13:100101. doi: 10.1016/j.ahjo.2022.100101. eCollection 2022 Jan.

Authors

Madhavi Kadiyala^{1

2}, Saikrishna Patibandla¹, Erin D Michos³

Affiliations

¹ Department of Medicine, Heart and Vascular Institute, West Virginia Univeristy, Morgantown, WV, United States of America.
² Department of Cardiology, St. Francis Hospital and Heart Center, Roslyn, NY, United States of America.
³ Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.

Abstract

Ischemia with non-obstructive coronary artery disease (INOCA), a common cause of angina, can occur due to coronary vasospasm, microvascular dysfunction, endothelial dysfunction, atherosclerosis or a combination of these mechanisms. We describe a case of adenosine-associated paradoxical coronary vasospasm and Takotsubo-like apical ballooning in a postmenopausal woman with underlying mild coronary atherosclerosis and microvascular dysfunction.

Keywords: Adenosine; Cardiac magnetic resonance imaging; Coronary vasospasm; Ischemia with non-obstructive coronary artery disease.