An unexpected acute coronary syndrome.

Summary: Acute coronary syndromes due to coronary artery vasospasm occur rarely and are difficult to diagnose in the acute setting. We present a patient with hypocalcaemia-induced coronary artery vasospasm, which resulted in an acute ST-elevation myocardial infarction. This was reversible upon administering intravenous calcium, with no long-term cardiac consequences for our patient.

Contributions of the study: Hypocalcaemia is a common clinical problem that is usually clinically quiescent, but in the acute setting can present with dramatic signs and symptomsHypocalcaemia resulting in an acute coronary syndrome is usually rapidly reversed by administering intravenous calcium.A hypocalcaemia-induced acute coronary syndrome is most likely a function of the myocardium being perfused primarily during diastole, with partial vasospasm limiting the diastolic flow during times of increased cardiac output or energy requirements.