September 1982

Coronary Artery Spasm With Sinus Node Dysfunction and Syncope

Author Affiliations

From the Divisions of Cardiology, The Holy Name of Jesus Hospital, Gadsden, Ala (Drs Bashour, Hakim, and Ennis); and the Department of Medicine, The George Washington University Medical Center, Washington, DC (Dr Cheng).

Arch Intern Med. 1982;142(9):1719-1721. doi:10.1001/archinte.1982.00340220143024

• In a 55-year-old man, attacks of spontaneous angina were associated with dizziness and syncope. Holter ECG monitoring disclosed evidence of sinus node dysfunction. Dizziness and syncope were corrected by a permanent ventricular demand pacemaker. Coronary cineangiography showed spontaneous, severe, diffuse spasm in a dominant left coronary artery and localized spasm in a nondominant right coronary artery. The patient died of pump failure shortly after cardiac catheterization. An autopsy disclosed only minimal coronary atherosclerosis. This patient's condition shows that (1) coronary spasm may cause sinus node dysfunction, dizziness, and syncope, (2) severe spasm that involves all the coronary artery branches may be fatal, and (3) severe spasm may occur in minimally diseased coronary arteries confirmed by pathologic examination.

(Arch Intern Med 1982;142:1719-1721)