Cardiac arrest associated with coronary artery spasm

Serious ventricular arrhythmias accompany spontaneous coronary spasm in up to 50% of episodes in susceptible patients, 1–4 and sudden death in patients with documented variant angina pectoris is not rare. 3,5 There are, however, few reports of patients presenting with ventricular fibrillation in whom the cause of the arrhythmia has been shown to be coronary spasm. Over a 5-year period in Seattle, 6 patients were resuscitated from out of hospital cardiac arrest due to ventricular fibrillation and were later shown to have coronary artery spasm. The evidence in these patients supports the contention that coronary spasm initiated ventricular fibrillation and suggests that this mechanism may be an important cause of the sudden cardiac death syndrome.