Chest
Volume 84, Issue 3, September 1983, Pages 302-304
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Serial Angiographic Evidence of Rapid Resolution of Coronary Artery Stenosis

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An example of rapid, spontaneous resolution of an eccentric coronary luminal narrowing from 95 percent to 80 percent and subsequently to 50 percent stenosis over a six-week time period is presented. Spontaneous thrombolysis is proposed as the explanation for these changes and is discussed with reference to existing experimental and clinical observations.

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CASE REPORT

A 50-year-old white man suffered a subendocardial myocardial infarction on March 9, 1982 documented by elevated cardiac enzymes and concurrent anterolateral ST-segment depression. His hospital course was complicated by postinfarction angina which was only partially responsive to maximal medical therapy with nitrates, propranolol (Inderal) and nifedipine. Because of continued anginal pain, the patient underwent cardiac catheterization on March 18, 1982 and was found to have a single eccentric

DISCUSSION

This patient demonstrates rapid spontaneous resolution of eccentric coronary luminal narrowing over a six-week period. Possible explanations for these changes include technical differences, spasm, recanalization, or spontaneous thrombolysis. Technical differences between studies are unlikely, as excellent filling occurred and at least three equivalent views of the vessel were taken during each study (30° RAO, 45° LAO cranial, and 60° LAO views). Coronary spasm is unlikely in view of the

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