Out-of-Hospital Cardiac Arrest due to Coronary Spasm with Recurrent Ventricular Fibrillation

We present a case of ventricular fibrillation (VF) secondary to ischaemia induced by coronary artery spasm. An 82-year-old man initially presented with an out-of-hospital VF arrest. On return of spontaneous circulation (ROSC), he was found to be in fast atrial fibrillation (AF); an invasive coronary...

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Bibliographic Details
Main Authors: Vrijraj Sinhji Rathod, Tanmay Kanitkar, Grigoris Karamasis
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2020/8823306
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Summary:We present a case of ventricular fibrillation (VF) secondary to ischaemia induced by coronary artery spasm. An 82-year-old man initially presented with an out-of-hospital VF arrest. On return of spontaneous circulation (ROSC), he was found to be in fast atrial fibrillation (AF); an invasive coronary angiogram revealed unobstructed coronary arteries. During his hospital stay, he developed chest pain, with concomitant ST elevation on ECG (electrocardiogram), which spontaneously resolved. A repeat coronary angiography revealed coronary spasm. Later, he had further ST elevation resulting in ventricular fibrillation. It became clear his initial presentation was most likely due to coronary vasospasm rather than a plaque-rupture or ventricular scar-related event, and he was thus successfully treated with multiple vasodilators and an implantable cardiac defibrillator. This case report highlights how conventional imaging modalities may not always lead to a diagnosis.
ISSN:2090-6404
2090-6412