# Case Report: Delayed diagnosis: a case of left main coronary artery spasm

## TL;DR

A rare case of left main coronary artery spasm was diagnosed nine years after initial symptoms, highlighting the importance of considering this condition in similar cases.

## Contribution

This case report adds to the understanding of LMCA spasm by illustrating a delayed diagnosis and its clinical implications.

## Key findings

- Initial CAG showed severe LMCA stenosis, leading to CABG surgery.
- Nine years later, CAG showed no significant stenosis, leading to LMCA spasm diagnosis.
- The case underscores the need for thorough clinical judgment to avoid misdiagnosis.

## Abstract

Left main coronary artery (LMCA) spasm is an exceedingly rare but potentially fatal condition. We present a case of severe stenosis of LMCA found by coronary angiography (CAG) due to recurrent chest pain, and subsequently received coronary artery bypass grafting (CABG). Nine years later, the patient was readmitted to the hospital because of precordial discomfort. During hospitalization, CAG was performed once again and showed no significant stenosis in the LMCA, leading to the diagnosis of LMCA spasm. This case emphasizes to interventional cardiologists the critical need to consider the possibility of LMCA spasm when diagnosing LMCA lesions. It highlights the importance of thorough and proactive pretreatment and comprehensive clinical judgment to minimize the risk of misdiagnosis.