• Venkata Satish Pendela, Pujitha Kudaravalli, Mamta Chhabria, and Mallory Balmer-Swain.
• Department of Internal Medicine, Rochester General Hospital, Rochester, NY, United States of America. Electronic address: Satish.pendela@rochesterregional.org.
• Am J Emerg Med. 2020 Aug 1; 38 (8): 1699.e1-1699.e3.

AbstractChest pain is one of the most common symptoms of patients presenting to the emergency department (ED) in the United States, accounting for up to eight million cases annually. We present a 55-year-old male who was brought in to the ED with sudden onset chest pain and was found to have ST-segment elevations in the infero-lateral leads on electrocardiogram (ECG). These changes resolved with nitroglycerin. Coronary artery vasospasm was diagnosed as coronary angiogram was normal. Calcium channel blocker was prescribed with good symptom relief. The most important teaching point is, coronary vasospasm as a cause of ST-segment elevation is missed frequently and should be considered among the differentials in patients presenting with chest pain. Nitrates and/or calcium channel blockers along with avoidance of triggers can help in symptom management.Copyright © 2020 Elsevier Inc. All rights reserved.

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