Recurrent syncope attributed to left main coronary artery severe stenosis

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Case Study

Background:

• Acute coronary syndrome (ACS) infrequently presents with recurrent syncope attributed to malignant ventricular arrhythmias.
• Severe coronary artery stenosis can precipitate life-threatening cardiac events.

Purpose of the Study:

• To report a rare case of acute coronary syndrome presenting with recurrent syncope due to ventricular tachycardia.
• To highlight the correlation between severe myocardial ischemia and ventricular arrhythmia.
• To emphasize the role of percutaneous coronary intervention (PCI) in managing such cases.

Main Methods:

• A case report of a 56-year-old male with symptoms of chest discomfort and syncope.
• Electrocardiogram (ECG) monitoring to detect ventricular tachycardia.
• Coronary angiography to assess coronary artery stenosis.
• Percutaneous coronary intervention (PCI) to revascularize stenotic arteries.

Main Results:

• The patient presented with paroxysmal chest burning, distress, and syncope.
• ECG revealed paroxysmal multimorphologic ventricular tachycardia.
• Coronary angiography showed severe stenosis in the left main (90%) and anterior descending (80%) arteries.
• PCI successfully placed stents, and the patient remained free of ventricular arrhythmia during a 3-month follow-up.

Conclusions:

• Ventricular tachycardia in this case was strongly correlated with persistent severe myocardial ischemia, likely triggered by coronary vasospasm.
• PCI is a recommended treatment for patients with concurrent severe coronary artery stenosis and ventricular arrhythmia.
• Addressing myocardial ischemia through PCI can effectively manage or resolve ventricular arrhythmia and prevent sudden cardiac arrest.