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Updated: Jul 4, 2025

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
An Unusual Case of Vasospastic Angina Resulting in Multiple Episodes of Cardiac Arrest
Francisco d'Orey1, Joao Nuno Patricio2, Maria Inês Ribeiro3
1Intensive Care Unit, Hospital Garcia de Orta, Almada, PRT.
Abstract:
Coronary vasospasm is a well-recognized cause of angina (also known as Prinzmetal angina) and a common cause of admissions to the emergency department and coronary intensive care units. It is however an uncommon cause of cardiac arrest. We describe a patient with multiple episodes of chest pain followed by cardiac arrest in pulseless electrical activity (PEA) due to coronary vasospasm. Telemetry and electrocardiography showed ST-segment elevation followed by PEA. Each event was short-lived and resolved after a maximum of six minutes of advanced life support measures. The patient was started on treatment with a dihydropyridine calcium channel blocker (CCB) and nitroglycerin patch with no further episodes recorded to date.
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