Automatic implantable cardioverter defibrillator for the treatment of ventricular fibrillation following coronary artery spasm: a case report.
Coronary artery spasm is an infrequently recognized condition that causes Prinzmetal's angina and specific electrocardiographic changes. A 50-year-old man who suffered a spontaneously aborted acute inferior myocardial infarction is presented. He underwent cardiac catheterization, which initially showed a normal coronary artery. The coronary angiogram was repeated shortly after a second presentation of acute coronary syndrome and ventricular fibrillation. Coronary spasm of very proximal right coronary artery was present, which was reversed completely with intracoronary nitroglycerin. The spasm segment was first stented. Subsequently, an automatic implantable cardioverter defibrillator was inserted because of the uncertainty of future spasm recurrence. The patient was discharged with oral isosorbide dinitrate and Amlodipine. In further follow-up, the patient had two separate shocks within 4 months of implantation. Ventricular fibrillation was the trigger for the shock therapy in both occasions.
Al-Sayegh
Ali
A
Division of Cardiology, Chest Diseases Hospital, P.O. Box 33439, Rawda, Kuwait. dr_alsayeq@hotmail.com
Shukkur
Abdul Mohammed
AM
Akbar
Moussa
M
D017311:Amlodipine / Q000627:therapeutic use; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications*; D017147:Defibrillators, Implantable; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D014665:Vasodilator Agents / Q000627:therapeutic use; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy*
D014665:Vasodilator Agents; D017311:Amlodipine; D007548:Isosorbide Dinitrate