Tan Nigel S, Almehmadi Fahad, Tang Anthony S L
Department of Medicine, University of Toronto, 399 Bathurst Street, East Wing 5-470, Toronto, ON M5T2S8, Canada.
Division of Cardiology, London Health Sciences Centre and Department of Medicine, Western University, C6-109, 339 Windermere Road, London, ON N6A 5A5, Canada.
Eur Heart J Case Rep. 2018 Mar 5;2(1):yty021. doi: 10.1093/ehjcr/yty021. eCollection 2018 Mar.
Coronary vasospasm is an uncommon but important cause of myocardial ischaemia and ventricular arrhythmias.
In this report, we present a striking example of vasospasm manifesting as ST-segment elevation and ventricular tachycardia on Holter monitoring. Later, spasm occurred during a procainamide challenge performed for suspected Brugada syndrome. The patient underwent implantable cardioverter-defibrillator insertion and was successfully treated with oral calcium channel blocker.
We review contemporary data regarding management and outcomes in coronary vasospasm and discuss the use of implantable defibrillator therapy in patients who have sustained a significant arrhythmic event.
冠状动脉痉挛是心肌缺血和室性心律失常的一个不常见但重要的原因。
在本报告中，我们展示了一个冠状动脉痉挛的显著例子，在动态心电图监测中表现为ST段抬高和室性心动过速。后来，在因疑似布加综合征进行普鲁卡因胺激发试验期间发生了痉挛。该患者接受了植入式心脏复律除颤器植入，并成功接受口服钙通道阻滞剂治疗。
我们回顾了关于冠状动脉痉挛管理和结局的当代数据，并讨论了在发生严重心律失常事件的患者中使用植入式除颤器治疗的情况。
