Coronary Vasospasm Mimicking ST-Elevation Myocardial Infarction in a Patient With ATRA-Induced Differentiation Syndrome: A case Report and Review of Literature

Khawar Maqsood, Ghazi Mirrani, Nosheen Sarwar, James F. Burke


All-trans retinoic acid (ATRA) has revolutionized the treatment of acute promyelocytic leukemia (APL). Differentiation syndrome is a frequent side effect of ATRA seen in patients with APL. We describe a case of chest pain with inferior ST elevations in a patient with ATRA induced differentiation syndrome. Patient was rushed for cardiac catheterization but his pain and EKG changes resolved after nitroglycerine administration in the catheterization lab. His coronary angiogram did not show any significant lesions raising concern for coronary vasospasm as the underlying cause for pain and EKG changes. Only one case of ATRA related MI has been described in literature before.



All-trans retinoic acid; Coronary vasospasm; Differentiation syndrome

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