Objective: To summarize the clinical experience of diagnosis and treatment of acute myocardial infarction caused by coronary artery spasm. Methods: A retrospective analysis of 12 patients with acute myocardial infarction who underwent coronary artery spasm from March 2014 to June 2019 was performed. Results: Through coronary angiography and intravascular ultrasound (IVUS) or optical coherence tomography(OCT), the diagnosis of different coronary artery spasm was confirmed. Eight patients (66.7%) of acute inferior myocardial infarction caused by right coronary artery spasm, 2 patients (16.7%) of acute anterior myocardial infarction caused by the left anterior descending coronary artery spasm, 2 patients (16.6%) of acute anterior and inferior myocardial infarction caused by three coronary arteryies spasm. The coronary artery spasm was disappeared after intracoronary administration of nitroglycerin. After treatment with nitrates, calcium antagonists and statins, the clinical symptoms of chest tightness and chest pain were relieved. Conclusion: Coronary angiography, IVUS and OCT can be used to diagnose acute myocardial infarction caused by coronary artery spasm and guide drug treatment effectively. The clinical effect of nitrate drugs and calcium antagonist drugs is significant.
