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Cardiac arrest related to coronary spasm in patients with variant angina: a three-case study
W Seniuk1, T Mularek-Kubzdela, M Grygier
1Cardiology Department, Karol Marcinkowski University School of Medical Sciences, ul.Starowiejska 1g/3, 61-664 Poznań, Poland. wseniuk@poczta.onet.pl
Insights
Variant angina pectoris can cause cardiac arrest. This study details three cases managed with high-dose calcium antagonists, nitrates, and device implantation for arrhythmias like ventricular fibrillation and atrioventricular block.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Variant angina pectoris (vasospastic angina) is characterized by coronary artery spasm.
- It can lead to serious cardiac events, including arrhythmias and cardiac arrest.
Observation:
- Three patients presented with variant angina pectoris and episodes of cardiac arrest.
- Clinical symptoms and electrocardiogram (ECG) ST-segment changes were typical.
- Coronary artery spasm was confirmed via arteriography in all cases.
Findings:
- Patients were treated with high-dose calcium antagonists and nitrates.
- One patient received an automatic cardioverter-defibrillator due to ventricular fibrillation despite medical therapy.
- Another patient underwent DDD pacemaker implantation for high-degree atrioventricular block.
Implications:
- Aggressive medical management with calcium antagonists and nitrates is crucial for variant angina.
- Implantable devices are necessary for managing life-threatening arrhythmias associated with coronary artery spasm.
- Understanding spasm-induced arrhythmias is vital for preventing sudden cardiac death.
Abstract:
We present three patients with variant angina pectoris and episodes of cardiac arrest. All of them had typical clinical symptoms, ST-segment changes in electrocardiogram, and coronary artery spasm confirmed by arteriography. They were treated with high doses of calcium antagonists and nitrates. An automatic cardioverter-defibrillator was implanted in the patient who developed ventricular fibrillation despite therapy with calcium antagonists. In another patient a DDD pacemaker was implanted because of high-degree atrioventricular block.