Coronary artery spasm at the site of angioplasty in the first 2 months after successful percutaneous transluminal coronary angioplasty.

The clinical course of five patients manifesting coronary artery spasm at the site of previous successful percutaneous coronary angioplasty is reviewed. All patients showed this spasm on hemodynamically insignificant (less than 50% diameter narrowing) obstruction. Four patients did not respond to therapy with calcium channel antagonists and nitrates and subsequently developed recurrent stenosis. One patient died 2 months after angioplasty and 1 day after coronary bypass surgery. Pathologic study at the site of angioplasty revealed new artherosclerotic disease. Coronary spasm may occur during the healing period after coronary angioplasty and should be distinguished from fixed obstruction.