Asymptomatic Coronary Artery Spasm and Severe Ventricular Arrhythmias

El vasoespasmo coronario generalmente evoluciona con episodios de dolor torácico y elevación del ST. No obstante, existen casos de vasoespasmo sin dolor torácico con taquiarritmias ventriculares documentadas. Su incidencia se desconoce y debe incluirse en el diagnóstico diferencial de taquicardia o fibrilación ventricular idiopática. En esta presentación se describe el caso de un paciente con historia de dos cuadros sincopales sin cardiopatía estructural aparente.Coronary artery spasm generally evolves with episodes of chest pain and ST elevation. However, there are cases of coronary artery spasm without chest pain with documented ventricular tachyarrhythmias. Its incidence is unknown and it should be included in the differential diagnosis of idiopathic ventricular tachycardia or fibrillation. The case of a patient with history of two syncopal episodes with no apparent structural heart disease is described in this work. Continuous ECG monitoring revealed episodes of ST elevation that led to polymorphic ventricular tachycardia. With the diagnosis of asymptomatic coronary artery spasm, a treatment with calcium channel blockers was begun and an automatic implantable cardioverter defibrillator was implanted.R EV ARGENT CARDIO