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Utilizing Cardiac Magnetic Resonance Imaging to Elucidate the Etiology of Sudden Cardiac Arrest

Yuta Takano1,2, Akira Taruya1, Shingo Ota1

  • 1Department of Cardiovascular Medicine, Wakayama Medical University, Japan.

Internal Medicine (Tokyo, Japan)
|April 20, 2025
PubMed

Insights

Sudden cardiac arrest (SCA) in a young woman was linked to coronary artery spasm, not blockages. Cardiac MRI helped identify this rare cause of SCA, highlighting the need for advanced imaging in unexplained cases.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Sudden cardiac arrest (SCA) lacks established etiological investigation methods.
  • Coronary artery spasm is an underdiagnosed cause of cardiac events.

Purpose of the Study:

  • To report a case of SCA due to coronary artery spasm in a young woman.
  • To highlight the utility of Cardiac Magnetic Resonance Imaging (CMR) in diagnosing coronary artery spasm as a cause of SCA.

Main Methods:

  • Case report of a young woman experiencing SCA.
  • Electrocardiography (ECG) and urgent coronary angiography.
  • Cardiac Magnetic Resonance Imaging (CMR) to assess myocardial edema.
  • Acetylcholine provocation test to confirm coronary artery spasm.

Main Results:

  • Patient presented with SCA (pulseless electrical activity) and chest pain.
  • ECG showed ST-segment depression; angiography revealed no significant stenosis.
  • CMR demonstrated myocardial edema without late gadolinium enhancement.
  • Acetylcholine test confirmed significant coronary artery spasm.

Conclusions:

  • Coronary artery spasm can precipitate SCA, even in young individuals without traditional risk factors.
  • CMR is a valuable tool for detecting myocardial edema in spasm-induced SCA.
  • Early diagnosis of coronary artery spasm is crucial to prevent recurrent events and manage hidden cardiac disease.

Keywords:
cardiac magnetic resonance imagingcoronary artery spasmsudden cardiac arrest

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