# Severe Multivessel Coronary Vasospasm From Hypovolemia: A Case Report

## TL;DR

A case report describes a rare instance where severe coronary vasospasm was caused by hypovolemia, leading to STEMI-like symptoms that resolved with fluid resuscitation.

## Contribution

This report highlights hypovolemia as a rare but important cause of severe multivessel coronary vasospasm.

## Key findings

- The patient's symptoms and EKG suggested STEMI, but angiography showed no thrombotic occlusion.
- Diffuse coronary vasospasm resolved with aggressive fluid resuscitation.
- Hypovolemia was identified as the underlying cause of the vasospasm.

## Abstract

Cases of coronary vasospasm leading to ST-elevation myocardial infarction (STEMI) have been described. However, hypovolemia as an etiology of coronary vasospasm has been rarely reported. We report the case of a 57-year-old male who presented to the hospital with syncope, with electrocardiogram (EKG) findings suggestive of ST elevation in the inferior leads. The catheterization lab was activated, and coronary angiography was performed, which showed no evidence of thrombotic occlusion with diffuse disease in the right coronary artery and left anterior descending artery that resolved with aggressive fluid resuscitation.