Coronary Artery Kinking, A Frequent Finding In Typical ACS Or AMI With Normal CAG

A patient comes with ECG changes pointing to ACS or AMI. The clinical picture and even enzymes point to AMI.Patient is being treated like that of AMI and the usual protocol followed. Then the assessment of Coronaries done by CAG. The anatomically normal coronaries noted by the cardiologist. To clear doubts, CT angiography is done to rule out Myocardial bridge in our cases as a routine.Then comes the question of why this ECG changes with typical clinical picture of chest pain, sweating, giddiness and palpitation.Patient also responded to treatment and mortality prevented. The answer lies in the following steps: 1.

Definite ECG changes present pointing to possible major lesion in any of the coronary arteries. 2. Lipid factors may or may not be present as in most of the cases. 3. Echo is usually reported as normal most of the time except rarely in stress cardiomyopathy during the acute…