Mr. Po, 70 years old, had angina for 10 years without a clear cause. Thanks to a drug-controlled coronary spasm test, he was diagnosed with coronary spasm.
Mr. Po often had chest pain for about 4-8 hours, not related to exertion, previous coronary angiography results were normal, taking anti-chest pain medications was ineffective. This time he went to Tam Anh General Hospital in Hanoi for examination, Master, Doctor Nguyen Tuan Long, Department of Cardiology, suspected coronary artery spasm so tested for controlled coronary artery spasm reaction with ergonovine.
On September 11, Dr. Long said that the drug ergonovine is used systemically in obstetrics, causing uterine contractions to help reduce postpartum blood loss. The new drug is applied in the field of cardiology in very small doses to cause coronary artery spasm. Doctors observe the coronary artery response in stressful situations of patients every day. “This is something that conventional coronary angiography cannot do, which can easily lead to missing the disease,” Dr. Long said.
This technique has been clinically proven to be effective in Asians such as Japan and Korea. In Vietnam, Tam Anh General Hospital is one of the first units to apply it to screen patients with chest pain of unknown cause, according to Dr. Long.
Image of coronary artery spasm causing narrowing of blood vessel diameter after injection of ergonovine. Photo: Tam Anh General Hospital
First, the doctor uses the Artis Pheno digital subtraction angiography (DSA) robotic system to evaluate the structure of the coronary artery branches. Then, the patient is injected with a small amount of ergonovine into the coronary artery to create a controlled constriction response.
After receiving the drug, the left coronary artery experienced a severe spasm, narrowing the blood vessel diameter by 99%. The patient experienced chest pain, and electrocardiogram changes suggestive of myocardial ischemia. The doctor concluded that Mr. Po had coronary spasm and prescribed an appropriate treatment regimen. He was discharged from the hospital after one day, and his chest pain was significantly reduced after two weeks.
Doctor Long examines Mr. Po. Photo: Tam Anh General Hospital
Coronary artery spasm is one of the main causes of ischemic heart disease with non-obstructive coronary artery lesions. If left untreated, it can lead to complications such as myocardial infarction, heart failure, and sudden death. The likelihood of complications may also increase if the patient has other underlying heart disease.
According to Dr. Long, the rate of patients with coronary artery spasm is high but there is a lack of diagnostic methods. When there is no accurate diagnosis, patients are often classified as having non-obstructive angina syndrome (syndrome X). Patients use general treatment drugs with low effectiveness. Meanwhile, if coronary artery spasm is accurately diagnosed, doctors can use targeted drugs with high effectiveness.
Smoking and drinking alcohol are the factors that cause the highest risk of coronary artery spasm. Doctors recommend quitting smoking, limiting alcohol, eating healthy, and exercising regularly. People with cardiovascular diseases such as lipid disorders, atherosclerosis, etc. need to have regular cardiovascular health check-ups.