title: Therapeutic procedures for coronary vasospasm-induced polymorphic ventricular tachycardia.
abstract: Coronary vasospasm is an unusual cause of angina and myocardial ischemia, with the potential to provoke acute myocardial infarction, malignant cardiac arrhythmias, and sudden cardiac death. The diagnosis is largely clinical and requires a high index of suspicion. Provocation studies are rarely performed due to the risks of the procedure and the relatively low incidence of disease. A subset of patients does not respond to conventional medical therapy and a paucity of evidence exists to guide therapy. While generally believed a multifocal phenomenon, there have been reports of successful treatment of focal, refractory vasospasm with coronary stent implantation. Furthermore, consideration of an implantable cardioverter defibrillator is warranted when vasospasm is complicated by lethal ventricular arrhythmias.
authors.affiliation: Vanderbilt University Medical Center, 905 Derby Trace, Nashville, TN 37211, USA. william.f.dresen@vanderbilt.edu
authors.forename: William F
authors.initials: WF
authors.lastname: Dresen
authors.forename: Quinn S
authors.initials: QS
authors.lastname: Wells
authors.forename: David J
authors.initials: DJ
authors.lastname: Maron
authors.forename: John A
authors.initials: JA
authors.lastname: McPherson
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003329:Coronary Vasospasm / Q000150:complications*; D017147:Defibrillators, Implantable; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D012307:Risk Factors; D016540:Smoking Cessation; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors