Coronary Vasospasm Masquerading as Coronary Artery Disease

Vasospastic angina, or Prinzmetal's angina, usually presents with chest pain. However, rare manifestations include ventricular fibrillation or cardiac arrest. Here, we discuss a case of a 78-year-old male who had recurrent episodes of syncope and was found to have ventricular fibrillation. He underwent coronary angiography and percutaneous intervention of the left anterior descending artery but continued to have syncope, which correlated with polymorphic ventricular fibrillation on an event monitor. Symptoms resolved with calcium channel blockers and nitrates, and the patient did not have further episodes of polymorphic ventricular tachycardia.