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Scholars Journal of Medical Case Reports | Volume-13 | Issue-05
Vasospastic Angina Confirmed by Nitrate Challenge: A Case Report
Donatien Mukeba Ntite, Mehdi Ayoub Laaroussi, Youssef Fihri, Nabil Laktib, Soumia Faid, Driss Britel, Hicham Faliouni, Zouhair Lakhal, Aatif Benyass
Published: May 21, 2025 |
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40
Pages: 1082-1084
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Abstract
A 61-year-old male smoker with hypertension presented with exertional chest pain and minor troponin elevation. ECG showed apico-lateral T wave inversions. A positive stress test led to coronary angiography, which revealed a subocclusion of the right coronary artery. After intracoronary nitrate injection, the lesion resolved completely, confirming coronary artery spasm. Vasospastic angina remains an underdiagnosed cause of chest pain and can mimic fixed coronary lesions, potentially leading to unnecessary interventions. Smoking is a key risk factor, and nitrate responsiveness is critical for diagnosis. This case highlights the importance of recognizing functional coronary obstruction and the role of nitrates in avoiding misdiagnosis.