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Fibrilación ventricular debida a vasospasmo coronario provocado por hiperventilación en un paciente con trastorno de
Shota Takimoto1, Shinichiro Masuda1, Shuzou Tanimoto1
1Department of Cardiology, Ageo Central General Hospital, Saitama, Japan.
European heart journal. Case reports
|September 2, 2025
Resumen
Los ataques de pánico pueden causar hiperventilación, lo que lleva a vasospasmo coronario y ritmos cardíacos peligrosos. Este caso destaca la importancia de considerar el vasospasmo coronario inducido por hiperventilación en pacientes con trastorno de pánico que experimentan dolor en el pecho.
Área de la Ciencia:
- Cardiología
- La psiquiatría
- Diagnóstico médico
Sus antecedentes:
- Los ataques de pánico pueden inducir hiperventilación, causando potencialmente vasospasmo coronario.
- El vasospasmo coronario puede conducir a isquemia miocárdica y arritmias potencialmente mortales.
- Diferenciar los síntomas del ataque de pánico del síndrome coronario agudo es clínicamente desafiante.
Objetivo del estudio:
- Para presentar un caso de fibrilación ventricular causada por el vasospasmo coronario inducido por hiperventilación durante un ataque de pánico.
- Hacer hincapié en la importancia de considerar el vasospasmo coronario inducido por hiperventilación en el diagnóstico diferencial del dolor torácico en pacientes con trastorno de pánico.
Principales métodos:
- Un hombre de 37 años con trastorno de pánico experimentó dolor en el pecho y pérdida de conciencia después de la hiperventilación.
- La electrocardiografía reveló fibrilación ventricular, tratada con éxito con la desfibrilación.
- Las pruebas de diagnóstico incluyeron una prueba de hiperventilación y una prueba de provocación de acetilcolina para confirmar el espasmo coronario.
Principales resultados:
- La prueba de hiperventilación indujo un 90% de espasmo coronario y dolor en el pecho.
- La provocación de acetilcolina reveló oclusión de bifurcación principal izquierda y cambios isquémicos.
- A pesar del tratamiento y las pruebas repetidas, la angina vasospática refractaria requirió un implante de desfibrilador cardioverter.
Conclusiones:
- La fibrilación ventricular en este caso probablemente se debió a un espasmo coronario provocado por la hiperventilación durante un ataque de pánico.
- Los médicos deben considerar el espasmo coronario inducido por hiperventilación como un diagnóstico diferencial en pacientes con trastorno de pánico con dolor en el pecho.
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