Rathod Vrijraj Sinhji, Kanitkar Tanmay, Karamasis Grigoris
Essex Cardiothoracic Centre, Basildon University Hospital, Nethermayne, Basildon, UK SS16 5NL.
Case Rep Cardiol. 2020 Sep 4;2020:8823306. doi: 10.1155/2020/8823306. eCollection 2020.
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.
我们报告一例继发于冠状动脉痉挛所致缺血的心室颤动（VF）病例。一名82岁男性最初表现为院外心室颤动骤停。自主循环恢复（ROSC）后，发现他处于快速心房颤动（AF）；侵入性冠状动脉造影显示冠状动脉无阻塞。在住院期间，他出现胸痛，同时心电图（ECG）上ST段抬高，随后自行缓解。重复冠状动脉造影显示冠状动脉痉挛。后来，他再次出现ST段抬高并导致心室颤动。很明显，他最初的表现很可能是由于冠状动脉痉挛，而非斑块破裂或与心室瘢痕相关的事件，因此他通过多种血管扩张剂和植入式心脏除颤器得到了成功治疗。本病例报告强调了传统成像方式可能并不总能得出诊断结果。
