Coronary vasospasm-induced polymorphic ventricular tachycardia: a case report and literature review

INTRODUCTION: Coronary vasospasm is an uncommon but important cause of myocardial ischaemia and ventricular arrhythmias. CASE PRESENTATION: In this report, we present a striking example of vasospasm manifesting as ST-segment elevation and ventricular tachycardia on Holter monitoring. Later, spasm occurred during a procainamide challenge performed for suspected Brugada syndrome. The patient underwent implantable cardioverter-defibrillator insertion and was successfully treated with oral calcium channel blocker. DISCUSSION: We review contemporary data regarding management and outcomes in coronary vasospasm and discuss the use of implantable defibrillator therapy in patients who have sustained a significant arrhythmic event.