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September 10, 2025JACC Case ReportsOpen Access

Recurrent Ventricular Fibrillation Due to Coronary Vasospasm Without Preceding ST-Segment Elevation or Chest Pain

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Authors

JWJeremy WilliamLFL. R. FerreiraAVAleksandr Voskoboinik

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Overview

Case study highlights recurrent ventricular arrhythmia without chest pain or ST-segment elevation, suggesting the need for careful ECG review.

Key Points

  • Cardiac arrest occurred in a patient despite no preceding chest pain, indicating atypical coronary vasospasm presentation.
  • Progressive ST-segment depression and T-wave inversion were observed prior to cardiac arrest, deviating from classic symptoms.
  • Coronary angiography revealed multivessel vasospasm, confirming the diagnosis after 3 months of investigation.
  • Provocation testing using acetylcholine played a crucial role in identifying vasospasm and guiding effective therapy.

Cite This Study

William et al. (2025) studied this question.

synapsesocial.com/papers/68c23dc5b210217d6478fac7https://doi.org/10.1016/j.jaccas.2025.104157
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Refractory Ventricular Fibrillation Associated With a Coronary Vasospasm and Fixed Moderate Coronary Stenosis2026
  2. 2Case Report: Sudden cardiac death due to spasm of multiple coronary arteries2025
  3. 3Occult Idiopathic Ventricular Fibrillation After Preoperative Cardiovascular Evaluation2026
  4. 4A Case Report of a Novel Approach to the Management of Refractory Coronary Vasospasm2025
  5. 5Intracoronary and Tailored Vasodilator Therapy for Refractory Ventricular Fibrillation Storm Triggered by Multivessel Coronary Spasm: A Case Report2026