Vasospastic angina resulting in sudden cardiac arrest, initially misdiagnosed as a psychiatric disorder

A 51-year-old-woman with a history of ablation therapy due to Wolff-Parkinson-White syndrome had been suffering from ambiguous chest pain, prompting investigation by several cardiologists. After being dissatisfied with a psychiatric disorder diagnosis, she was admitted to our hospital for further investigation. She lost her consciousness due to a sudden cardiac arrest shortly after admission. A provocation test indicated vasospastic angina associated with a diffuse spastic pattern of her left anterior descending artery. <Learning objective: This case demonstrates that implantation of a cardioverter defibrillator may be avoided if the angiographic pattern of the vasospasm is recognized, the condition is correctly diagnosed, and appropriate medications are prescribed.>.