Recurrent Syncope and Ventricular Arrhythmias Induced by Coronary Artery Spasm.

ABSTRACT

We present a case of recurrent coronary artery spasm induced ventricular arrhythmias. A 73-year-old female developed a syncopal episode requiring brief cardiopulmonary resuscitation (CPR) with later spontaneous resolution and bradycardia. During admission, the patient had a recurrent syncopal episode while in supine position. Upon reviewing cardiac monitor, it was noted that the syncope coincided with a series of recorded arrhythmias. Invasive cardiac angiogram revealed a non-obstructive lesion at the right coronary artery with no other abnormalities suggesting spastic activity as the source of the arrhythmia. Subsequently, the patient successfully underwent an Implantable Cardioverter- Defibrillator (ICD) placement and stenting in the right coronary. Patient symptoms resolved and no further arrhythmias were detected in the ICD recording.