JACC. Case reports · 2026
Dynamic Resolution of Coronary Vasospasm: The Clasp-Knife Sign.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Sezgin Ali, Kurklu Hacı Ali, Avara Ayse, Ucar Oguz, Gullu Hakan
Аннотация
BACKGROUND: Coronary vasospasm may mimic acute coronary occlusion and ST-segment elevation myocardial infarction, potentially leading to unnecessary interventions if not recognized.
CASE SUMMARY: A 32-year-old woman with no prior medical history presented with acute chest pain and inferior ST-segment elevation. Emergency coronary angiography demonstrated apparent complete occlusion of the proximal right coronary artery with absent distal flow. Before any mechanical intervention, intracoronary nitroglycerin was administered, resulting in abrupt restoration of vessel patency with normalization of luminal caliber and TIMI flow grade 3. This dynamic change created a characteristic appearance resembling the sudden opening of a clasp knife. The patient was managed conservatively with vasodilator therapy and remained clinically stable.
DISCUSSION: This case highlights a distinctive angiographic manifestation of coronary vasospasm. Recognition of this phenomenon, termed the clasp-knife sign, may help differentiate vasospastic occlusion from thrombotic coronary obstruction and prevent unnecessary coronary intervention.
CASE SUMMARY: A 32-year-old woman with no prior medical history presented with acute chest pain and inferior ST-segment elevation. Emergency coronary angiography demonstrated apparent complete occlusion of the proximal right coronary artery with absent distal flow. Before any mechanical intervention, intracoronary nitroglycerin was administered, resulting in abrupt restoration of vessel patency with normalization of luminal caliber and TIMI flow grade 3. This dynamic change created a characteristic appearance resembling the sudden opening of a clasp knife. The patient was managed conservatively with vasodilator therapy and remained clinically stable.
DISCUSSION: This case highlights a distinctive angiographic manifestation of coronary vasospasm. Recognition of this phenomenon, termed the clasp-knife sign, may help differentiate vasospastic occlusion from thrombotic coronary obstruction and prevent unnecessary coronary intervention.