Recurrent acute coronary syndrome caused by refractory vasospastic angina in a patient with essential thrombocythemia: a case report

This case underscores the role of coronary spasm in recurrent ACS in patients with ET and highlights the potential side effects of anagrelide. A multidisciplinary diagnostic approach, including OCT and histopathological evaluation and spasm provocation, can help to identify the underlying pathophysiology of ACS. Tailored therapy, verified through invasive provocation tests under vasodilation, successfully controlled the symptoms and prevented recurrence.