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[Coronary spasm and heart arrest caused by ventricular fibrillation]
J Vara1, G Alvarez, J L Lambert
1Servicio de Cardiología, Hospital Central de Asturias, Oviedo.
Insights
Three young, heavy-smoking men experienced cardiac arrest from coronary artery spasm, despite normal initial heart tests. Prompt diagnosis and treatment with calcium antagonists or nitrates led to full recovery and symptom resolution.
Area of Science:
- Cardiology
- Clinical Medicine
- Pharmacology
Background:
- Coronary artery spasm is a potential cause of cardiac arrest, particularly in young individuals.
- Atypical chest pain can be a symptom of underlying coronary artery issues.
- Standard cardiac diagnostic tests may not always detect coronary spasm.
Observation:
- Three young, heavy-smoking men presented with cardiac arrest due to ventricular fibrillation.
- All patients reported atypical chest pain, but exercise testing, echocardiograms, and coronary angiography were normal.
- Diagnosis was achieved through Holter monitoring and provocative testing with ergonovine or acetylcholine.
Findings:
- Coronary artery spasm was identified as the cause of cardiac arrest in these patients.
- Diagnostic methods like Holter monitoring and provocative testing were crucial for diagnosis.
- Treatment with calcium antagonists and/or nitrates proved effective.
Implications:
- This case series highlights the importance of considering coronary artery spasm in young patients with cardiac arrest and atypical chest pain, even with normal initial investigations.
- Early diagnosis and appropriate pharmacotherapy can lead to favorable outcomes.
- Further research into the mechanisms and optimal management of coronary artery spasm in this demographic is warranted.
Abstract:
We report the cases of three young men, heavy smokers, without previous heart disease and who were resuscitated after cardiac arrest due to ventricular fibrillation attributed to coronary spasm. All of them complained of atypical chest pain and the exercise testing, echocardiogram and coronary angiography were normal. The first case was diagnosed by Holter monitoring and by provocative testing with intracoronary ergonovine; the second by provocative testing with intracoronary acetylcholine and the third by Holter monitoring. The patients were treated with a calcium antagonist and/or nitrates and in the follow up they remained asymptomatic.