What is Twisted Coronary Artery Syndrome?

I am afraid there is no such thing. There may be tortuous coronary arteries, and there is an Acute Coronary Artery Syndrome.

Tortuous coronary arteries are sometimes the result of atherosclerosis and have more than usual turns in their course over the surface of the heart. This then may become a problem if an intervention with a (straight) Percutaneous Coronary Intervention (PCI) or stent is considered across a localized blockage of an artery with a tight turn.  This by the way would not be a concern with a bypass operation (CABG).

Acute Coronary Artery Syndrome (ACS) includes unstable angina and two forms of myocardial infarction in which heart muscle is damaged. These types are named according to the appearance of the EKG as non-ST segment elevation myocardial infarction (NSTEMI) and ST segment elevation myocardial infarction (STEMI).


If the ECG confirms changes suggestive of a heart attack, medication is injected that dissolves blood clots obstructing the coronary arteries, or a Percutaneous Coronary Intervention (PCI) may be performed. Data suggest that rapid transfer and treatment is essential.


If the ECG does not show typical changes, the term "non-ST segment elevation ACS" is applied. The patient may still have suffered a "non-ST elevation MI" (NSTEMI). The accepted management of unstable angina and acute coronary syndrome is treatment with medications alone.

Hope this helps,

Dr T



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