Key result
A patient with spasm-induced myocardial infarction developed accelerated idioventricular rhythm after nitroglycerin infusion, which sustained for 5 days without hemodynamic instability and resolved spontaneously.
Case Report (n=1)
No
This case demonstrates that accelerated idioventricular rhythm, a common reperfusion arrhythmia, can unusually persist for up to 5 days without hemodynamic compromise following spasm-induced myocardial infarction.
May support expectant management of prolonged AIVR without instability in spasm-MI; leaves open incidence and predictors in larger cohorts.
A 56-year-old man presented with right coronary arterial spasm accompanied by ST segment elevation in the inferior leads. A reperfusion arrhythmia, accelerated idioventricular rhythm (AIVR), developed 1 hour after a nitroglycerin infusion. The AIVR was sustained for 5 days without hemodynamic instability, and resolved spontaneously during hemodynamic monitoring in the coronary intensive care unit.
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Kim et al. (2009) conducted a case report in Spasm-induced myocardial infarction and accelerated idioventricular rhythm (n=1). Nitroglycerin infusion was evaluated on Clinical course of accelerated idioventricular rhythm. A patient with spasm-induced myocardial infarction developed accelerated idioventricular rhythm after nitroglycerin infusion, which sustained for 5 days without hemodynamic instability and resolved spontaneously.
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