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Coronary artery spasm may be involved in the genesis of various cardiac disorders, such as myocardial infarction, unstable angina, syncope, sudden cardiac death, transient heart failure, and atypical chest symptoms.1–5) According to the past reports, coronary artery spasm in Japanese has three times higher prevalence than Caucasian.6–8) Yasue and Okumura reported the usefulness of acetylcholine (ACh) spasm provocation test for the induction of coronary artery spasm in patients with variant angina.9–11) ACh spasm provocation test become a popular method for the induction of coronary artery spasm in the worldwide during more than a quarter century. We recently reported that abnormal response has increased in Japanese patients by using ACh spasm provocation tests and its cause may be concerned the increase of metabolic syndrome.12) Japanese corporate warrior works in the world. When they work in the foreign countries and become sick, they may not obtain the information and the therapy about the disease in such a domestic patient. Coronary spasticity about racial differences between Caucasian and Japanese is already permeated. However, Japanese cardiologists recognize less racial differences about heart disease between Japanese patients and Southeast Asian patients. We experienced a meaningful case that we should transmit the importance of coronary artery spasm in even Southeast Asia and here we report this case in this article.

nihon kan shikkan gakkai zasshi

A Case of Urgent PCI after Diagnosis of Acute Coronary Syndrome in a Japanese Man with Unobstructed Coronary Arteries during Posted Overseas in Southeast Asia