What is the clinical evidence from this study?

Study design: Case Report. Population: Vasospastic angina and MINOCA (n=1). Intervention: Diltiazem, nitrates, and ICD implantation.

What does this research mean for the field?

Vasospastic angina in the setting of MINOCA can trigger life-threatening polymorphic ventricular arrhythmias, for which ICD implantation should be considered to prevent sudden death. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To report a case of myocardial infarction with non-obstructive coronary arteries caused by severe epicardial coronary vasospasm that triggered malignant ventricular arrhythmia.

September 15, 2026European Heart Journal Supplements

Diltiazem, nitrates, and an ICD resolve vasospastic angina causing polymorphic VT in a MINOCA case.

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Population

51-year-old man presenting with MINOCA due to vasospastic angina, complicated by polymorphic ventricular…

Design

Case_report

Key result

In a 51-year-old man with MINOCA, vasospastic angina caused transient ST elevation and rapid polymorphic ventricular tachycardia, which was managed with diltiazem, nitrates, and an ICD.

Authors

DBD Barbisan NGN Gasparetto VMV Menegon

Discussion

Member takes

Overview

Coronary spasm merits consideration in MINOCA with rest symptoms; single case leaves open need for systematic provocative testing.

Key Points

To report a case of myocardial infarction with non-obstructive coronary arteries caused by severe epicardial coronary vasospasm that triggered malignant ventricular arrhythmia.
Evaluated a 51-year-old male presenting with chest pain at rest using serial troponin T testing, echocardiography, cardiac MRI, and coronary angiography.
Tracked cardiac rhythm and transient ischemic episodes via continuous inpatient telemetry in a coronary intensive care unit.
Angiography confirmed non-obstructive coronary artery disease with under 50% stenosis despite troponin T elevation from 53 to 205 ng/l and a normal cardiac MRI.
Telemetry documented a 4-minute episode of transient ST elevation that progressed directly into rapid, polymorphic ventricular tachycardia.
Medical treatment with diltiazem and nitrates eliminated further ST-elevation episodes, and a bicameral implantable cardioverter-defibrillator was placed for sudden death prevention.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 51-year-old man presenting with MINOCA and vasospastic angina complicated by polymorphic ventricular tachycardia.

Intervention

Diltiazem, nitrates, and implantation of a bicameral implantable cardiac defibrillator (ICD).

Outcome

Resolution of transient ST elevation and prevention of sudden cardiac death.

Vasospastic angina can present as MINOCA and be complicated by life-threatening polymorphic ventricular arrhythmias, warranting consideration of ICD implantation alongside medical therapy.

Cite This Study

Barbisan et al. (2026) conducted a case report in Vasospastic angina and MINOCA (n=1). Diltiazem, nitrates, and ICD implantation was evaluated. In a 51-year-old man with MINOCA, vasospastic angina caused transient ST elevation and rapid polymorphic ventricular tachycardia, which was managed with diltiazem, nitrates, and an ICD.

synapsesocial.com/papers/6aa9016aeed42882c1fc189f https://doi.org/10.1093/eurheartjsupp/suag058.518

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September 15, 2026European Heart Journal Supplements

Diltiazem, nitrates, and an ICD resolve vasospastic angina causing polymorphic VT in a MINOCA case.

View Full Paper

Ask AI

Bookmark

Population

51-year-old man presenting with MINOCA due to vasospastic angina, complicated by polymorphic ventricular…

Design

Case_report

Key result

In a 51-year-old man with MINOCA, vasospastic angina caused transient ST elevation and rapid polymorphic ventricular tachycardia, which was managed with diltiazem, nitrates, and an ICD.

Authors

DBD Barbisan NGN Gasparetto VMV Menegon

Discussion

Member takes

Overview

Coronary spasm merits consideration in MINOCA with rest symptoms; single case leaves open need for systematic provocative testing.

Key Points

To report a case of myocardial infarction with non-obstructive coronary arteries caused by severe epicardial coronary vasospasm that triggered malignant ventricular arrhythmia.
Evaluated a 51-year-old male presenting with chest pain at rest using serial troponin T testing, echocardiography, cardiac MRI, and coronary angiography.
Tracked cardiac rhythm and transient ischemic episodes via continuous inpatient telemetry in a coronary intensive care unit.
Angiography confirmed non-obstructive coronary artery disease with under 50% stenosis despite troponin T elevation from 53 to 205 ng/l and a normal cardiac MRI.
Telemetry documented a 4-minute episode of transient ST elevation that progressed directly into rapid, polymorphic ventricular tachycardia.
Medical treatment with diltiazem and nitrates eliminated further ST-elevation episodes, and a bicameral implantable cardioverter-defibrillator was placed for sudden death prevention.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 51-year-old man presenting with MINOCA and vasospastic angina complicated by polymorphic ventricular tachycardia.

Intervention

Diltiazem, nitrates, and implantation of a bicameral implantable cardiac defibrillator (ICD).

Outcome

Resolution of transient ST elevation and prevention of sudden cardiac death.

Vasospastic angina can present as MINOCA and be complicated by life-threatening polymorphic ventricular arrhythmias, warranting consideration of ICD implantation alongside medical therapy.

Cite This Study

synapsesocial.com/papers/6aa9016aeed42882c1fc189f https://doi.org/10.1093/eurheartjsupp/suag058.518

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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