# Coronary Vasospasm Masquerading as Coronary Artery Disease

## TL;DR

A 78-year-old man with syncope and ventricular fibrillation was found to have coronary vasospasm, not artery disease, and improved with medication.

## Contribution

This case highlights coronary vasospasm as a rare cause of syncope and ventricular fibrillation, mimicking coronary artery disease.

## Key findings

- The patient's symptoms resolved with calcium channel blockers and nitrates.
- Polymorphic ventricular tachycardia episodes ceased after treatment.
- Coronary angiography did not fully explain the clinical presentation.

## Abstract

Vasospastic angina, or Prinzmetal's angina, usually presents with chest pain. However, rare manifestations include ventricular fibrillation or cardiac arrest. Here, we discuss a case of a 78-year-old male who had recurrent episodes of syncope and was found to have ventricular fibrillation. He underwent coronary angiography and percutaneous intervention of the left anterior descending artery but continued to have syncope, which correlated with polymorphic ventricular fibrillation on an event monitor. Symptoms resolved with calcium channel blockers and nitrates, and the patient did not have further episodes of polymorphic ventricular tachycardia.