Aborted sudden cardiac death in a 52-yearold man without structural heart disease
Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation(2008)
摘要
Abstract Sudden cardiac death in the absence of apparent structural heart disease is an uncommon phenomenon. The majority of these
patients do not have ‘normal’ hearts and specific diagnostic tools are required to identify structural or functional abnormalities.
We describe the history of a 50-yearold man who survived ventricular fibrillation. Clinical investigation, including a coronary
angiography and electrophysiological study, appeared to be normal. An implantable cardioverter defibrillator was inserted.
Follow-up Holter monitoring was performed after a recurrent episode of ventricular tachycardia. It demonstrated transient
ST-segment elevation. An acetylcholine provocation test was subsequently carried out. Reversible coronary spasm of the left
descending coronary artery was found, during which a diagonal branch was occluded. It may be concluded that coronary spasm
provocation is of value in the routine diagnostic work-up of patients surviving sudden cardiac death without apparent heart
disease. (Neth Heart J 2008;16:239-41.)
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关键词
coronary spasm,ventricular fibrillation
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