Aggressive Treatment of Refractory Coronary Artery Vasospasm in a Patient with Malignant Ventricular Tachyarrhythmia and Cardiac Arrest


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DOI:

https://doi.org/10.58600/eurjther-186

Keywords:

Vasospastic coronary angina, Sudden cardiac arrest, Sympatectomy

Abstract

Coronary artery vasospasm (CAVS) is a clinical entity that can cause angina, but also unstable angina pectoris, acute myocardial infarction, fatal arrhythmias, and sudden death. Although it is a condition that is usually controlled with medical treatment, more aggressive treatments may rarely be required. In this case, the patient with a known diagnosis of CAVS had multiple arrests despite optimal medical treatment. We observed that fatal arrhythmias persisted in the Implantable Cardioverter Defibrillator (ICD) records, even though we implanted a stent and gave the patient maximal medical treatment. We performed sympathectomy as a last resort and we did not detect any recurrence in the 6-month follow-up of the patient. ICD implantation and sympathectomy should always be considered in resistant CAVS cases.

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References

Prinzmetal M, Kennamer R, Merliss R, et al. Angina pectoris. I. A variant form of angina pectoris; preliminary report. Am J Med. 1959;27:375–388.

Picard F, Sayah N, Spagnoli V, et al. Vasospastic angina: a literature review of current evidence. Arch Cardiovasc Dis. 2019;112(1):44–55.

Anthony Matta, Frederic Bouisset, Thibault Lhermusier, Fran Campelo-Parada, Meyer Elbaz, et al. Review Article Coronary Artery Spasm: New Insights. Journal of Interventional Cardiology. Volume 2020, Article ID 5894586, 10 pages.

Giovanni P. Talaricoa, Maria L. Crostab, Maria B. Giannicoa, Francesco Summariaa, Leonardo Calo, et al. Cocaine and coronary artery diseases: a systematic review of the literatüre. J Cardiovasc Med 2017, 18:291–294

Swarup S, Patibandla S, Grossman SA. Coronary Artery Vazospazm. NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.

Takaoka K, Yoshimura M, Ogawa H, et al. Comparison of the risk factors for coronary artery spasm with those for organic stenosis in a Japanese population: role of cigarette smoking. Int J Cardiol. 2000;72(2):121–126.

Min Chul Kim, Youngkeun Ahn, Keun Ho Park, Doo Sun Sim, Nam Sik Yoon, et al. Clinical outcomes of low-dose aspirin administration in patients with variant angina pectoris. International Journal of Cardiology. Volume 167, Issue 5, 1 September 2013, Pages 2333-2334.

Al-Khatib et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. JACC VOL. 72, NO. 14, 2018.

Matsueet al. Clinical Implications of an ImplantableCardioverter-Defibrillator in Patients WithVasospastic Angina and Lethal Ventricular Arrhythmia. Journal of the American College of Cardiology. Vol. 60, No. 10, 2012. NO. 4, 510-515 https://doi.org/10.1080/20009666.2021.1915534

JCS Joint Working Group. Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary Spastic Angina) (JCS 2013). Circ J 2014;78:2779–801.

Yaowang Lina, Huadong Liua, Danqing Yub, Meishan Wua, Qiyun Liua, et al. Sympathectomy versus conventional treatment for refractory coronary artery spasm. Coronary Artery Disease 2019, 30:418–424

Cardona-Guarache R, Pozen J, Jahangiri A, Koneru J, Shepard R, RobertsC, et al. Thoracic sympathectomy for severe refractory multivessel coronaryartery spasm. Am J Cardiol 2016; 117:159–161.

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Published

2023-03-30

How to Cite

Doğan, M., Kaya, E. B., Deniz, Çiğdem, Canpolat, U., Şahiner, M. L., Ateş, A. H., & Aytemir, K. (2023). Aggressive Treatment of Refractory Coronary Artery Vasospasm in a Patient with Malignant Ventricular Tachyarrhythmia and Cardiac Arrest . European Journal of Therapeutics, 29(1), 94–96. https://doi.org/10.58600/eurjther-186

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Original Articles