Key result
A 71-year-old man with Prinzmetal angina and normal coronary angiography survived vasospastic-induced ventricular fibrillation and was successfully treated with an ICD and vasodilator therapy.
Why the study?
Data are lacking on the management of patients receiving appropriate vasodilator medications who present with ventricular fibrillation due to coronary artery vasospasms.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
This case highlights the potential for coronary vasospasm to cause life-threatening ventricular fibrillation and suggests considering ICD placement for secondary prevention in such patients despite current guidelines not explicitly recommending it.
Coronary artery vasospasms have been known to cause episodic angina pectoris, along with ST-T wave changes. In addition, vasospasm if prolonged can cause myocardial ischemia leading to malignant arrhythmias such as ventricular fibrillation and ventricular tachycardia resulting in sudden cardiac death (SCD). Treatment for this disorder can be challenging. Current data is lacking on the management of patients receiving appropriate vasodilator medications who present with Ventricular Fibrillation (VFib) as a consequence of coronary artery vasospasms. We present a case of a 71-year-old man who was hospitalized due to recurrent episodes of coronary vasospasms leading to acute decompensation and VFib with subsequent resuscitation while undergoing cardiac catheterization. We also provide review of the literature and updates on the current guidelines from the American Heart Association on this potentially life-threatening disorder.
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Patel et al. (2020) conducted a case report in Vasospastic-Induced Ventricular Fibrillation (n=1). Implantable Cardioverter Defibrillator (ICD) and vasodilator therapy was evaluated. A 71-year-old man with Prinzmetal angina and normal coronary angiography survived vasospastic-induced ventricular fibrillation and was successfully treated with an ICD and vasodilator therapy.
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