DOI: 10.25881/20728255_2021_16_3_103


Bocharov A.V.1, Blinov A.S.1, Popov L.V.2

1 Kostroma Regional Clinical Hospital named after Korolev E.I., Kostroma

2 National Medical and Surgical Center named after N.I. Pirogov of the Ministry of Healthcare of the Russian Federation


The article presents a clinical case of interventional treatment of a patient with vasospastic angina and acute coronary syndrome with St segment elevation, life-threatening arrhythmia of the type of atrial fibrillation, which required stenting of the local vasospasm zone. Data on possible treatment strategies for this category of patients is extremely scarce and does not always coincide with clinical recommendations. The case described below clearly demonstrates the relevance of these problems in real clinical practice.

Keywords: vasospastic angina, type 2 myocardial infarction, percutaneous coronary intervention.


1. Matsue Y, Yoshida K, Hoshino M, et al. Clinical features and prognosis of type 2 myocardial infarction in vasospastic angina. Am. J. Med. 2015; 128(4): 389-395.

2. Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal. 2018; 39: 119-177. doi:10.1093/eurheartj/ ehx393.

3. Agewall S, Beltrame J.F, Reynolds HR, et al. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries. European Heart Journal. 2017; 38: 143-153. doi:10.1093/eurheartj/ehw149.

4. Thygesen K, Alpert J, Jaffe A, et al. Fourth universal definition of myocardial infarction (2018). European Heart Journal. 2019; 40: 237-269. doi:10.1093/eurheartj/ehy462.

5. Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. European Heart Journal. 2020; 41: 407-477. doi:10.1093/eurheartj/ehz425.

6. Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease. J. Am. Coll. Cardiol. 2014; 64 (18): 1929-1949.

7. Inamura Y, Nishizaki M, Shimixu M, et al. Early repolarization and positive T-wave alternans as riskmarkers for life threalening arrythmias in patients with vasospastic angina. Int. J. Cardiol. 2015; 196: 7-13.

8. Nagayoshi Y, Kawano H, Kojima S, et al.Guidlines foe diagnosis and treatment of patients with vasospastic angina (coronary spastic angina) (JCS 2013). Circ. J. the Japanese Circulation Society. 2014; 78(11): 2779-2801.

For citation

Bocharov A.V., Blinov A.S., Popov L.V. Vasospastic angina and acute coronary syndrome with st segment elevation. Bulletin of Pirogov National Medical & Surgical Center. 2021;3(16):103-105. (In Russ.)