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Diffuse triple-vessel coronary spasm as a cause of asystole and syncope

Qiang Liu1, Chengzhi Gao1, Cuixia Liu1

  • 1Department of Cardiology, The Fourth People's Hospital of Jinan, Medical School, Tai Shan Medical College, Jinan, PR China.

The American Journal of Emergency Medicine
|August 18, 2015
PubMed

Insights

Coronary artery spasm can cause syncope. This case highlights diffuse, three-vessel coronary artery spasm as a cause of unexplained syncope and asystole.

Area of Science:

  • Cardiology
  • Pathophysiology
  • Clinical Medicine

Background:

  • Vasospasm is a key factor in ischemic heart disease, potentially leading to myocardial infarction and sudden death.
  • Coronary artery spasm typically affects single vessels, but diffuse involvement can occur.
  • Widespread coronary artery spasm can cause significant ischemia, leading to serious cardiac events.

Observation:

  • A patient presented with syncope attributed to documented, diffuse vasospasm affecting three major coronary arteries.
  • The vasospasm was severe enough to cause widespread myocardial ischemia.

Findings:

  • Diffuse coronary artery vasospasm involving three major vessels can manifest as unexplained syncope.
  • This condition can lead to life-threatening arrhythmias, including asystole.

Implications:

  • Clinicians should consider coronary artery spasm as a potential cause of unexplained syncope, especially when diffuse.
  • Early recognition and management of coronary artery spasm are crucial to prevent fatal outcomes.
  • This case underscores the importance of investigating vasospasm in patients with syncope and cardiac events.

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