Severe Prinzmetal's Angina Inducing Ventricular Fibrillation Cardiac Arrest

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Prinzmetal's angina, a coronary artery vasospasm, can present as acute coronary syndrome.
• It rarely causes ventricular arrhythmias and cardiac arrest, but survivors face high risks of recurrence and sudden cardiac death.
• Normal cardiac function and optimal medical therapy do not eliminate this risk.

Observation:

• A healthy 48-year-old female experienced ventricular fibrillation arrest.
• She subsequently had recurrent ventricular tachyarrhythmias attributed to Prinzmetal's angina.

Findings:

• Survivors of these cardiac events face a high risk of recurrent arrhythmias and sudden cardiac death.
• This risk persists despite normal cardiac function and optimal medical management.

Implications:

• This patient subgroup warrants consideration for an implantable cardioverter defibrillator (ICD).
• Early consideration of ICDs may reduce mortality in high-risk Prinzmetal's angina survivors.