case_images: PMC11799933_01
case_images: (A) Control electrocardiogram on admission (left panel), electrocardiogram during chest pain showed ST elevation in leads V3-6 (arrows) (right panel). (B, C) Spasm provocation test. Control angiography of the left coronary artery (B). Angiography after injection of 100 mg of acetylcholine into the left coronary artery revealed spasm of the distal portion of the left anterior descending artery (arrows) (C). (D, E) The resulting flow-mediated dilation response. Time course of flow-mediated dilation (D). Maximum percentage flow-mediated dilation change is 5.1% (arrows). x-axis: time (seconds). y-axis: percentage flow-mediated dilation change (%). Image of the resting (left panel) and maximum (right panel) flow-mediated dilation test (E). FMD, flow-mediated dilation.
case_images: ytaf026f1.jpg
case_images: PMC11799933_01_ytaf026f1.jpg
case_images: ytaf026-F1
case_images: He experienced chest pain with ST-segment elevation in leads V3-6 on electrocardiogram during the night that he was hospitalized (Figure 1A). However, intracoronary administration of 100 mug of acetylcholine during a spasm provocation test induced a spasm in the left anterior descending artery (Figure 1B and C). Flow-mediated dilation (FMD) of the brachial artery showed decreased endothelial function with impaired FMD (5.1%) (Figure 1D and E).