Atrioventricular Block Induced by Right Coronary Artery Spasm in Vasospastic Angina
Key result
Verapamil resolves symptoms and halts conduction abnormalities in a case of RCA spasm-induced AV block.
- n=1
Why the study?
Vasospastic angina is a reversible cause of myocardial ischemia that may rarely be associated with conduction disturbances.
Population
A 64-year-old man presenting with nocturnal rest angina
Design
Case report
Authors
Discussion
Loading...
Member takes
Implication
Raises awareness of VSA with transient AV block causing syncope; leaves open incidence and management strategies.
Key Points
- To highlight the association between right coronary artery spasm and atrioventricular block in vasospastic angina.
- Patient presented with nocturnal rest angina and underwent initial angiography which was normal.
- Holter monitoring revealed transient ST-segment elevation with Mobitz type I second-degree AV block progressing to 2:1 AV block.
- Revealed diffuse coronary vasospasm in repeat angiography, treated with verapamil.
- Transient AV block was observed during symptoms, leading to presyncope.
- Angiography confirmed right coronary artery spasm, resolved with nitrates.
- Follow-up showed symptom resolution with no further conduction abnormalities after verapamil treatment.
Study Design
Type
Case Report (n=1)
Structured PICO
P
Population
A 64-year-old man with nocturnal rest angina who developed transient atrioventricular block due to right coronary artery spasm.
I
Intervention
Verapamil therapy
O
Outcome
Symptom resolution and absence of further conduction abnormalities during follow-up
Right coronary artery vasospasm should be considered as a reversible cause of unexplained atrioventricular block or syncope, which can be effectively managed with calcium-channel blockers.
Cite This Study
Trimaille et al. (2026) conducted a case report in Vasospastic angina with atrioventricular block (n=1). Verapamil was evaluated on Symptom resolution and conduction abnormalities. Verapamil therapy resulted in symptom resolution and no further conduction abnormalities in a patient with atrioventricular block induced by right coronary artery spasm.