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Case Reports: Unusual association of diseases/symptoms
Refractory coronary vasospasm and recurrent cardiac arrest
  1. Antoinette S Birs,
  2. Douglas Darden,
  3. Eric D Adler and
  4. Gregory K Feld
  1. Department of Cardiology, UC San Diego Health System, La Jolla, California, USA
  1. Correspondence to Dr Antoinette S Birs; abirs{at}health.ucsd.edu

Abstract

We present a case of recurrent vasospasm as an uncommon cause of ventricular fibrillation in a young female patient who was found to have a genetic mutation of unknown significance in the desmoplakin (DSP) gene and ultimately required an implantable cardiac defibrillator and percutaneous coronary intervention. Refractory vasospasm as a cause of chest pain and cardiac arrest may be under-recognised. In this manuscript, we highlight the natural history of refractory vasospasm, treatment considerations including medical therapy, implantable cardiac defibrillator and percutaneous coronary intervention. Lastly, we explore the potential correlation between the DSP mutation and her clinical presentation and the growing importance of genetic testing in unexplained cardiac arrest.

  • Arrhythmias
  • Interventional cardiology
  • Pacing and electrophysiology
  • Clinical diagnostic tests
  • Cardiovascular system

https://doi.org/10.1136/bcr-2022-253884

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    Footnotes

    • Twitter @AntoinetteBirs

    • Contributors ASB made substantial contributions to the concept and design of the study as well as carried out the data acquisition and analysis. She drafted the work and revised it for intellectual content. She agreed to all aspects of the work and gave a final approval for publication and agreed to be held accountable for all aspects of the work. DJD made substantial contributions to the analysis and interpretation of the data, and revised the work to enhance intellectual content. He gave final approval for publication and agreed to be accountable for the work in regard to its integrity and accuracy. EDA made substantial contributions to the concept and design of the work and was an integral part of revising the work for important intellectual content. He gave final approval of the version to be published and agreed to be accountable for all aspects of the work. GKF made substantial contributions to the conception and design of the work. He made contributions to revising the work for critical and intellectual content. He gave final approval of this version for publication and agreed to be accountable for all aspects of the work related to accuracy or integrity.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.