Coronary artery spasm should be considered as a potential cause of chest pain and life-threatening ventricular tachyarrhythmias in patients with mitral valve prolapse syndrome.
Coronary spasm may trigger ventricular arrhythmias in mitral valve prolapse; single case leaves open need for prospective confirmation.
A 54-year-old man with mitral valve prolapse syndrome diagnosed by echocardiography complained of anginal pain associated with ventricular tachyarrhythmia. One day he suddenly lost consciousness, and ECG at that time revealed ventricular fibrillation. Thereafter, he developed ST elevation, sporadic premature ventricular contractions, and R on T phenomenon leading to ventricular fibrillation during the attack of anginal pain. His coronary arteriogram was normal. This case implies that coronary artery spasm may be one of the causes of chest pain and ventricular tachyarrhythmias in patients with mitral valve prolapse syndrome.
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Sakuma et al. (1985) studied this question.
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