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Unleashing an Underlying Serious Cardiac Arrhythmia: A Case of Coronary Vasospasm With Atypical Presentation
Muhammad A Baig1, Ahmed Elmogy1, Yasser Hegazy2
1Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.
Insights
Coronary artery vasospasm can cause syncope and ventricular arrhythmia, even with normal heart catheterization. Prompt diagnosis and calcium channel blocker treatment are key for managing this atypical cardiac condition.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Case Study
Background:
- Coronary artery vasospasm is a condition where coronary arteries constrict, potentially causing myocardial ischemia.
- Atypical presentations of coronary artery vasospasm can mimic other cardiac conditions, delaying diagnosis.
Abstract:
This case report highlights the atypical presentation of coronary artery vasospasm in a 59-year-old patient presenting with syncope due to ventricular arrhythmia. Despite initially elevated troponin levels and non-significant lesions observed during left heart catheterization, the patient experienced recurrent chest pain and dizziness, prompting further evaluation. Ultimately, coronary vasospasm was identified as the likely differential diagnosis, supported by various diagnostic modalities including electrocardiogram, Zio patch monitoring, transthoracic echocardiogram, cardiac MRI, and CT angiography. Management involved the initiation of calcium channel blocker therapy, leading to a non-eventful follow-up in the cardiology clinic.
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