Korean J Med.  2010 Nov;79(5):559-562.

A case of three-vessel coronary artery spasm presenting with aborted sudden cardiac death

• Kim YB
• Seol SH
• Kim DK
• Kim U
• Yang TH
• Kim DI
• Kim DS

Abstract

A 51-year-old female patient was referred to the emergency department with a 5-h history of resting chest pain. The patient, who had been diagnosed with variant angina six months previously, had not used her medications within two days of presentation. Electrocardiography (ECG) revealed a T wave inversion on lead I, AVL, and all precordial leads. Two hours later, the patient's chest pain was suddenly aggravated with an ST segment elevation noted from leads V2-6, leading to shock. Emergency management, including cardiopulmonary resuscitation (CPR), was initiated. Coronary angiography showed diffuse multifocal narrowing of three vessels; however, the vessels recovered following the intracoronary injection of nitroglycerin. The patient went into cardiac arrest two more times during continuous nitroglycerin infusion. The attacks were managed using CPR and sublingual nifedipine. Here, we describe a rare case of life-threatening three-vessel coronary vasospasm and its successful management with calcium channel blockers.

Keyword

Coronary spasm; Sudden cardiac arrest

MeSH Terms

Calcium Channel Blockers
Cardiopulmonary Resuscitation
Chest Pain
Coronary Angiography
Coronary Vasospasm
Coronary Vessels
Death, Sudden, Cardiac
Electrocardiography
Emergencies
Female
Heart Arrest
Humans
Middle Aged
Nifedipine
Nitroglycerin
Shock
Spasm
Calcium Channel Blockers
Nifedipine
Nitroglycerin