Recurrent pulseless electrical activity in a patient with coronary vasospasm and supravalvular aortic stenosis: a case report

Abstract

BackgroundPulseless electrical activity cardiac arrest is associated with poor outcomes and the identification of potentially reversible reasons for cardiac arrest is fundamental.Case presentationWe describe the case of a 46-year-old male with the rare coincidental finding of supravalvular aortic stenosis and coronary vasospasm leading to recurrent pulseless electrical activity cardiac arrest. Extracorporeal life support was successfully applied for hemodynamic stabilization. Supravalvular aorticstenosis underwent surgical repair. The patient survived five time resuscitation and was discharged after full neurological recovery.ConclusionsCoronary vasospasm and supravalvular aortic stenosis are rare but potentially reversible causes of pulseless electrical activity cardiac arrest. Extracorporeal life support allows accurate diagnostic and possibly therapy even of uncommon reasons for cardiac arrest.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0284-5) contains supplementary material, which is available to authorized users.

Cardiogenic Shock due to Pulseless Electrical Activity Arrest Associated with Severe Coronary Artery Spasm

“…Implantable-cardioverter defibrillator (ICD) was found to be effective in suppressing the next serious fatal event in patients with coronary spastic angina as well as structural heart disease ( 1 ). However, some patients with pulseless electrical activity (PEA) arrest due to coronary spasm die after the implantation of ICD ( 2 - 6 ). We herein report a case of spontaneous severe coronary spasm that was resuscitated from catastrophic cardiogenic shock due to severe spasm accompanying PEA arrest.…”