ST-segment elevation and diminution of prostate-specific antigen in a patient with coronary spasm and without significant coronary stenoses.

Many patients with acute coronary syndrome (ACS) had no culprit lesion. Coronary spasm is a frequent cause of ACS and should regularly be considered as a differential diagnosis. Prostate-specific antigen (PSA) is an established marker for detection of prostate cancer. Both elevated as well as diminished PSA have been reported during acute myocardial infarction(AMI) and our preliminary observations have concluded that when elevation of PSA occurs during AMI, coronary lesions are frequent and often more severe than when a diminution of PSA occurs. Moreover, our preliminary observations have concluded also that when elevation of prostate-specific antigen occurs during AMI, it seems to relate to a higher occurrence of major adverse cardiac events in the first 8 days after AMI than when a diminution of PSA occurs. We present a case of ST-segment elevation in a patient with diminution of PSA, coronary spasm and without significant coronary stenoses. Our report extends the evaluation of PSA during ACS.