Tabriz University of Medical Sciences Journal of Cardiovascular and Thoracic Research 2008-5117 8 3 2016 09 30 Spontaneous multi-focal coronary artery spasm: a case report 137 139 10.15171/jcvtr.2016.28 EN Mohammad Ali Ostovan Mahdi Sajedi Khanian Sahand Hamidi Mostafa Fattahi Pooyan Dehghani Journal Article 10.15171/jcvtr.2016.28 2016 06 23 2016 09 07 Spontaneous coronary artery vasospasm is one of the important causes of acute chest pain syndromes. The diagnosis of diffuse multifocal spasm can be quite challenging and it could be easily mistaken for diffuse coronary artery disease. The use of intracoronary nitroglycerin can relieve spasm and reveal the real extent of coronary artery disease. Herein we present a case presenting with acute myocardial infarction due to severe coronary artery spasm that had even received fibrinolytic therapy. Multiple narrowing was shown during coronary angiography and the patient was scheduled for percutaneous coronary intervention (PCI). But after intracoronary (IC) injection of nitroglycerin, all of lesions disappeared completely and the diagnosis of coronary spasm was confirmed.