Recurrent Ventricular Fibrillation Due to Coronary Vasospasm Without Preceding ST-Segment Elevation or Chest Pain.

ABSTRACT:

Background

Coronary vasospasm (CV) is a rare cause of malignant ventricular arrhythmia and cardiac arrest. It typically presents with chest pain and marked ST-segment elevation.

Case summary

We present the case of a 61-year-old man with recurrent malignant ventricular arrhythmia and implantable defibrillator shocks without preceding chest pain. The diagnosis of CV remained elusive for 3 months despite extensive investigation. Close inspection of telemetry revealed progressive ST-segment depression and T-wave inversion before arrest. Coronary angiography with low-dose acetylcholine testing revealed multivessel vasospasm. Vasodilator therapy was initiated with rapid elimination of ventricular arrhythmia.

Discussion

This case highlights that cardiac arrest due to CV may

SUBMITTER: William J 

PROVIDER: S-EPMC12441568 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature