# An Unusual Case of Vasospastic Angina Resulting in Multiple Episodes of Cardiac Arrest

## TL;DR

A rare case of vasospastic angina led to multiple cardiac arrests, which were successfully managed with specific medications.

## Contribution

This case highlights an uncommon cause of cardiac arrest and effective treatment with calcium channel blockers and nitroglycerin.

## Key findings

- Coronary vasospasm caused multiple episodes of pulseless electrical activity cardiac arrest.
- Treatment with dihydropyridine calcium channel blocker and nitroglycerin patch prevented further episodes.
- Telemetry confirmed ST-segment elevation preceding cardiac arrest events.

## Abstract

Coronary vasospasm is a well-recognized cause of angina (also known as Prinzmetal angina) and a common cause of admissions to the emergency department and coronary intensive care units. It is however an uncommon cause of cardiac arrest. We describe a patient with multiple episodes of chest pain followed by cardiac arrest in pulseless electrical activity (PEA) due to coronary vasospasm. Telemetry and electrocardiography showed ST-segment elevation followed by PEA. Each event was short-lived and resolved after a maximum of six minutes of advanced life support measures. The patient was started on treatment with a dihydropyridine calcium channel blocker (CCB) and nitroglycerin patch with no further episodes recorded to date.