The hidden culprit: Coronary Spasm Mimicking NSTEMI: A Case Study

Coronary artery spasm is a rare but significant cause of myocardial ischemia, often presenting as non-ST-elevation myocardial infarction (NSTEMI). We report the case of a 61-year-old male with cardiovascular risk factors including recently diagnosed hypertension and active smoking, who presented with acute chest pain. Coronary angiography revealed plaques with less than 50% stenosis and a spastic lesion in the right coronary artery (RCA). The patient responded well to medical therapy and demonstrated stable hemodynamics during follow-up. This case underscores the importance of recognizing coronary artery spasm in NSTEMI and highlights the role of clinical, imaging, and angiographic findings in its diagnosis and management.