Intravenous diltiazem rapidly relieved chest pain and restored sinus rhythm in a patient with complete atrioventricular block caused by coronary artery spasm without adverse effects.
Case Report (n=1)
No
Does intravenous diltiazem reverse complete atrioventricular block caused by coronary artery spasm?
Intravenous diltiazem can effectively and safely reverse complete AV block induced by coronary artery spasm, despite theoretical concerns of exacerbating AV block.
Coronary artery spasm (CAS) is characterized by reversible diffuse or focal vasoconstriction, a phenomenon that plays an important role in the pathogenesis of ischemic heart disease. Fatal arrhythmias, such as ventricular tachycardia/fibrillation and complete atrioventricular block (AV-B), are very common in patients with CAS. Nondihydropyridine calcium channel blockers (CCBs) such as diltiazem were recommended as first-line medications for treating and preventing CAS episodes. However, its use remains controversial in CAS patients with AV-B as this type of CCB can also cause AV-B itself. Here, we present the use of diltiazem in a patient with complete AV-B caused by CAS. The patient's chest pain was rapidly relieved, and complete AV-B was promptly restored to sinus rhythm following the administration of intravenous diltiazem without any adverse effects. In this report, we highlight the useful and effective application of diltiazem for treating and preventing complete AV-B caused by CAS.
Zhang et al. (Mon,) conducted a case report in Coronary artery spasm-induced complete atrioventricular block (n=1). Diltiazem was evaluated on Restoration of sinus rhythm and relief of chest pain. Intravenous diltiazem rapidly relieved chest pain and restored sinus rhythm in a patient with complete atrioventricular block caused by coronary artery spasm without adverse effects.
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