Coronary vasospasm as an etiology of recurrent ventricular fibrillation in the absence of coronary artery disease: a case report.
Binita BhandariTejaswi KanderiKeerthi YarlagaddaMehreen QureshiSaketram KomanduriPublished in: Journal of community hospital internal medicine perspectives (2021)
Background: Vasospastic angina (VA), or Prinzmetal's angina, is characterized by symptoms of coronary angina caused by coronary vasospasm, usually in the absence of atherosclerotic changes. It typically presents with chest pain, which can be accompanied by transient electrocardiographic changes, if visualized during the attack. It can also rarely present with severe manifestations of acute myocardial angina, ventricular fibrillation, or cardiac arrest. Case presentation: We present a case of a 50-year-old Caucasian male who initially presented to the hospital with chest pain and was diagnosed with VA. Later, he was brought to the hospital by emergency medical services later with ventricular fibrillation, despite normal coronary anatomy on angiogram. He was managed with placement of an intra-cardiac defibrillator (ICD) for secondary prevention. The patient continued to have recurrent episodes of ventricular fibrillation with associated ICD shocks, and had multiple admissions to the hospital with similar presentations. Symptoms and arrhythmia improved after optimizing antianginal therapy. Conclusions: Ventricular fibrillation can be an uncommon but severe manifestation during VA crises. In cases with normal coronary vasculature, it is important to recognize VA as a cause of recurrent ventricular fibrillation in order to optimize medical management for prevention of fatal arrhythmias.
Keyphrases
- coronary artery disease
- left ventricular
- coronary artery
- heart failure
- catheter ablation
- percutaneous coronary intervention
- healthcare
- coronary artery bypass grafting
- cardiovascular events
- aortic stenosis
- cardiac arrest
- cardiac resynchronization therapy
- subarachnoid hemorrhage
- mitral valve
- left atrial
- atrial fibrillation
- primary care
- early onset
- acute care
- emergency medical
- type diabetes
- cardiovascular disease
- drug induced
- acute respiratory distress syndrome
- hepatitis b virus
- depressive symptoms
- intensive care unit
- congenital heart disease
- transcatheter aortic valve replacement