Recurrent acute coronary syndrome due to coronary artery spasm in different coronary arteries.

Coronary artery spasm (CAS) plays an important role in the pathogenesis of a wide variety of ischemic heart diseases. Several case reports have shown that CAS due to hypocalcemia can mimic myocardial infarction. However, in all these cases there were coexisting electrolyte abnormalities or other medical conditions that are risk factors for coronary spasm. We describe recurrent acute coronary syndrome in an otherwise healthy young woman without cardiac risk factors caused by coronary spasms, alternatively occurring in all three major coronary arteries. <Learning objective: Isolated hypocalcemia may cause acute coronary artery spasm, leading to recurrent acute coronary syndrome. This unusual cause of recurrent acute coronary syndrome occurred in a young, otherwise healthy female with no risk factors for coronary artery diseases. Medical treatment would resolve the spasm in the large majority of the patients. However, in patients having medically resistant vasospasm, mechanical revascularization may be an option.>.