Adepoju Deborah, Smith Jamie A L, Leslie Stephen J
Cardiac Unit, Raigmore Hospital, Inverness IV2 3UJ, UK.
Case Rep Cardiol. 2022 Jul 27;2022:4504028. doi: 10.1155/2022/4504028. eCollection 2022.
Coronary artery vasospasm is the sudden narrowing of an artery caused by rapid prolonged contraction. It reduces blood supply to the heart and can present with typical cardiac chest pain symptoms. Vasospasm can lead to fatal arrhythmic complications such as ventricular fibrillation. Our case report describes an example of this occurring in a 53-year-old female, and the management plan that ensued. We look at the importance of accurate and prompt diagnosis of vasospasm and how this can have implications for treatment options. One of the available treatments for vasospasm is placement of an implantable cardioverter defibrillator (ICD). This delivers a shock in the event of future life-threatening arrhythmia, with the aim of preventing cardiac arrest. ICD placement, however, is not always a suitable option. This case report discusses the various challenges that arose while making the decision for ICD placement and gives insight into the best available treatment options for coronary artery vasospasm. We also highlight early warning signs that predict life-threatening vasospastic events and how this can be diagnosed and treated appropriately.
冠状动脉痉挛是指由于快速持久收缩导致动脉突然变窄。它会减少心脏的血液供应，并可能出现典型的心脏胸痛症状。血管痉挛可导致致命的心律失常并发症，如室颤。我们的病例报告描述了一名53岁女性发生这种情况的实例以及随后的管理计划。我们探讨了准确及时诊断血管痉挛的重要性以及这对治疗选择的影响。血管痉挛的一种可用治疗方法是植入式心脏复律除颤器（ICD）的植入。在未来发生危及生命的心律失常时，它会输送电击，目的是预防心脏骤停。然而，ICD植入并不总是一个合适的选择。本病例报告讨论了在决定植入ICD时出现的各种挑战，并深入探讨了冠状动脉痉挛的最佳可用治疗选择。我们还强调了预测危及生命的血管痉挛事件的早期预警信号以及如何对其进行适当的诊断和治疗。
