Key result
CCB, nitrate, and ICD therapy successfully prevents recurrent arrest in Prinzmetal angina.
Why the study?
Prinzmetal angina rarely causes ventricular arrhythmias and cardiac arrest, but survivors remain at high risk for recurrent events and sudden cardiac death despite normal cardiac function and optimal medical therapy.
Case Report (n=1)
Survivors of cardiac arrest secondary to Prinzmetal's angina should be considered for ICD implantation in addition to optimal medical therapy to prevent recurrent sudden cardiac death.
Answers are grounded in this paper and cite their sources.
Supports ICD consideration with medical therapy post-arrest in Prinzmetal angina; hypothesis-generating and requires prospective validation.
Prinzmetal's angina is a vascular spasm of the coronary artery that can mimic acute coronary syndrome. It is rarely responsible for ventricular arrhythmias and cardiac arrest; however, survivors with these complications are at increased risk for recurrent ventricular arrhythmias and sudden cardiac death. This is true despite the presence of normal cardiac function and optimal medical therapy. Thus, this select population should be considered for an implantable cardioverter defibrillator (ICD). In this case vignette, we describe a healthy 48-year-old female with ventricular fibrillation arrest, followed by recurrent ventricular tachyarrhythmias caused by Prinzmetal's angina.
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Khiatah et al. (2020) conducted a case report in Prinzmetal's angina with ventricular fibrillation cardiac arrest (n=1). Amlodipine, isosorbide mononitrate, and implantable cardioverter defibrillator (ICD) was evaluated. In a 48-year-old female with Prinzmetal's angina complicated by ventricular fibrillation arrest, combination therapy with calcium channel blockers, nitrates, and an ICD effectively prevented recurrent events.
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