title: Recurrent pulseless electrical activity in a patient with coronary vasospasm and supravalvular aortic stenosis: a case report.
abstract: BACKGROUND
  Pulseless electrical activity cardiac arrest is associated with poor outcomes and the identification of potentially reversible reasons for cardiac arrest is fundamental.
  
  
  METHODS
  We describe the case of a 46-year-old male with the rare coincidental finding of supravalvular aortic stenosis and coronary vasospasm leading to recurrent pulseless electrical activity cardiac arrest. Extracorporeal life support was successfully applied for hemodynamic stabilization. Supravalvular aorticstenosis underwent surgical repair. The patient survived five time resuscitation and was discharged after full neurological recovery.
  
  
  CONCLUSIONS
  Coronary vasospasm and supravalvular aortic stenosis are rare but potentially reversible causes of pulseless electrical activity cardiac arrest. Extracorporeal life support allows accurate diagnostic and possibly therapy even of uncommon reasons for cardiac arrest.
authors.affiliation: Heart Center, Department of Cardiology and Angiology I, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. achim.lother@universitaets-herzzentrum.de.
authors.forename: Achim
authors.initials: A
authors.lastname: Lother
authors.affiliation: Heart Center, Department of Cardiovascular Surgery, University of Freiburg, Freiburg, Germany.
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Beyersdorf
authors.affiliation: District Hospital Loerrach, Medical Clinic, Loerrach, Germany.
authors.forename: Hans H
authors.initials: HH
authors.lastname: Osterhues
authors.affiliation: Heart Center, Department of Cardiology and Angiology I, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Bode
authors.affiliation: Heart Center, Department of Cardiology and Angiology I, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Wengenmayer
mesh_terms: D021921:Aortic Stenosis, Supravalvular / Q000150:complications* / Q000175:diagnosis; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods; D003329:Coronary Vasospasm / Q000150:complications* / Q000175:diagnosis; D004562:Electrocardiography; D015199:Extracorporeal Membrane Oxygenation; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011674:Pulse; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac arrest; Coronary vasospasm; ECLS; Pulseless electrical activity; Supravalvular aortic stenosis