Coronary artery spasm is a major cause of sudden cardiac arrest in survivors without underlying heart disease.
BACKGROUND
The role of coronary spasm in underlying disease-free patients who were resuscitated from sudden cardiac arrest remained uncertain. This study investigated the cause of cardiac arrest, and the etiologic and prognostic differences were compared between patients with underlying heart disease (group I) and those patients without underlying heart disease (group II).


METHODS
Twenty-five survivors of sudden cardiac arrest were classified into two groups according to the presence or absence of underlying heart disease. To investigate the cause of cardiac arrest, we performed ergonovine testing and electrophysiologic study. Fifteen of the patients had underlying heart disease, while 10 did not.


RESULTS
Electrophysiologic abnormalities were found in 13 of the 15 patients in group I. In group II, spontaneous attack of coronary spasm occurred in four patients during the observation period, and coronary spasm was induced in three of the remaining six period of 32 +/- 23 months, whereas no patients in group II had recurrence of sudden cardiac arrest at a median follow-up of 32 months (range, 10 to 72 months).


CONCLUSIONS
Electrophysiologic study identified a potential cause in 13 of 15 patients with underlying heart disease. Coronary spasm was involved in the pathogenesis of sudden cardiac arrest in survivors without identifiable underlying heart disease.
Igarashi
Y
Y
First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Tamura
Y
Y
Suzuki
K
K
Tanabe
Y
Y
Yamaguchi
T
T
Fujita
T
T
Yamazoe
M
M
Aizawa
Y
Y
Shibata
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002304:Cardiac Pacing, Artificial; D017023:Coronary Angiography / Q000187:drug effects; D003329:Coronary Vasospasm / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology* / Q000401:mortality; D006801:Humans; D008133:Long QT Syndrome / Q000150:complications / Q000401:mortality; D008297:Male; D008755:Methylergonovine; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000401:mortality
D008755:Methylergonovine