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A 35-year-old female patient, weight 54 kg, height 173 cm,BMI 18.0 was admitted to our PCI center for acute anteriorSTEMI. Routine myocardial necrosis marker CK 737, cTnT1.0 was positive. From cardiovascular risk factors; 15 ciga-rettes/a day and taking contraception pills. She was a pro-fessional handball player a few years ago and now occa-sionally plays handball in the Veterans League. 6 days priorto admission after the game, she felt retrosternal pain ex-tending into the epigastrium. The pain reoccurred on thenext day, the dyspepsia was diagnosed, she was hospita-lized in an outpatient clinic, underwent gastroscopy with ne-gative results. ECG was performed on several occasionswhich showed no abnormality detected. On the day of relo-cation, the pain reoccurred starting in the upper abdomenaccompanied with hypotension and ECG changes. We per-formed primary PCI which showed occlusion of high proxi-mal segment of the LAD without thrombus formation. RCAwas dominant with smooth walls with retrograde collateralsto LAD appearing only fragmentary. Acx hypoplastic alsowithout atherosclerotic changes. The guidewire was introdu-ced through the site of occlusion in LAD up to the apex andextensive balloon dilatation with different diameters was per-formed without success and with pronounced “recoil phe-nomenon”

cardiologia croatica

Anterior wall acute ST-segment elevation myocardial infarction probably due vasospastic occlusion of proximal left anterior descending artery: to stent or not to stent