title: [Diagnosis and treatment of spastic angina revealed by cardiac arrest].
abstract: The prevalence of vasospastic angina is said to be low in Europe, but maybe because of a lack of diagnosis in the daily practice. However, coronary spasm is a common cause of cardiac arrest, especially among patients free of cardiac illness, and it should be systematically investigated after an unexplained cardiac arrest. Intracoronary spasm provocation test exposes patients to a lower risk compared to the risk of spontaneous spastic angina. Accurate modalities and diagnostic criteria have to be clarified for European population. Avoiding external causes of coronary spasm (such as cigarette smoking or more generally consuming coronary spasm inducing drugs) and prescribing antispastic medicine (first of all calcium channel blockers) are the basis of vasospastic angina treatment. However, recurrent coronary spasms have been reported despite an appropriate treatment and implantable automatic defibrillator has been implanted after case discussion when the onset of illness was cardiac arrest. We report the case of a patient recovering from cardiac arrest who had a positive spasm coronary provocation test, and was treated with calcium channel blockers and had been an automatic defibrillator implanted, with a coronary spasm provocation test performed afterward still contentious. While discussing this case, we are making a literature review of the diagnosis and treatment of spastic angina revealed by cardiac arrest.
authors.affiliation: Hôpital Foch, 40, rue Worth, 92150 Suresnes, France; CHU Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Centre hospitalier régional d'Orléans, 14, avenue de l'Hôpital, 45067 Orléans, France. Electronic address: xdufretay@orange.fr.
authors.forename: X
authors.initials: X
authors.lastname: Halna du Fretay
authors.affiliation: Hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
authors.forename: D
authors.initials: D
authors.lastname: Mohammed Saeed
authors.affiliation: Hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Institut cardiovasculaire Paris Sud, 6, avenue du Noyer-Lambert, 91300 Massy, France; Hôpital européen de Paris-la-Roseraie, 120, avenue de la République, 93300 Aubervilliers, France.
authors.forename: H
authors.initials: H
authors.lastname: Benamer
mesh_terms: D000328:Adult; D017311:Amlodipine / Q000627:therapeutic use; D000787:Angina Pectoris / Q000175:diagnosis* / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003329:Coronary Vasospasm / Q000175:diagnosis* / Q000628:therapy*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008297:Male; D014700:Verapamil / Q000627:therapeutic use
chemical_list: D002121:Calcium Channel Blockers; D017311:Amlodipine; D014700:Verapamil
keywords: Arrêt cardiorespiratoire; Cardiac arrest; Coronary artery spasm; Coronary spasm provocation testing; Défibrillateur automatique implantable; Ergonovin; Ergonovine; Implantable cardiac defibrillator; Spasme coronaire; Test de provocation