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Journal of Medical Case Reports

, 9:86

First Online: 22 April 2015Received: 23 September 2014Accepted: 29 January 2015DOI: 10.1186-s13256-015-0537-4

Cite this article as: Choi, W., Kim, Y.N. & Kim, KH. J Med Case Reports 2015 9: 86. doi:10.1186-s13256-015-0537-4


IntroductionMoyamoya disease is characterized by progressive steno-occlusive changes of the distal internal carotid and developed collateral vasculature, so called ‘moyamoya’ vessels at the base of the brain. Variant angina is a rare occurrence in patients with moyamoya disease.

Case presentationHere we report the case of a 41-year-old Korean woman who developed chest pain after indirect revascularization surgery of moyamoya disease. A treadmill test and an exercise stress echocardiograph showed positive results, but there was no significant major coronary arteries stenosis. Suspicious of vasospasm, we conducted an ergonovine spasm stimulation test, which demonstrated tight stenosis of her proximal left anterior descending artery. At the site of spasm, intravascular ultrasound virtual histology showed intraluminal fibrous plaque.

ConclusionPhysicians who follow up patients with moyamoya disease would need to be aware of the possibility of cardiac ischemia as well as neurological manifestations.

KeywordsCoronary artery disease Moyamoya disease Variant angina AbbreviationsCAGCoronary angiography

IVUS-VHIntravascular ultrasound virtual histology

LADLeft anterior descending artery

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Autor: Woong Choi - Yu Na Kim - Kyung-Hee Kim


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