Prinzmetal Angina: A Case of Recurrent Ventricular Fibrillation

  • Lali Gujejiani Associate Professor, European University, Tbilisi, Georgia
  • Kakhaber Latsuzbaia Invited Lecturer, East European University, Tbilisi, Georgia
  • Jaba Tsivilashvili Invited Lecturer, Caucasus International University, Tbilisi, Georgia
  • Khatuna Jalabadze Associate Professor, Tbilisi State Medical Academy, Georgia
  • Maia Kharebashvili Assistant Professor, Caucasus International University, Tbilisi, Georgia
  • Nato Jinjolia Georgian-American University (GAU), Tbilisi, Georgia
  • Vakhtang Tetradze Invited Lecturer, Tbilisi State Medical University, Georgia
  • Iamze Taboridze David Aghmashenebeli University of Georgia, Tbilisi, Georgia
Keywords: Vasospastic angina, dissection coronary artery, Treatment

Abstract

Prinzmetal angina (also known as vasospastic or variant angina) is characterized by episodic coronary artery spasms, leading to transient ischemia and angina, often accompanied by ST elevation on ECG. While typically non-myocardial infarction in nature, severe cases can progress to life-threatening complications such as ventricular fibrillation (VF). This report details the case of a 66-year-old male with hypertension and a history of aortic root replacement, presenting with recurrent VF secondary to coronary vasospasm despite optimal medical therapy. ECG showed ST elevation, and coronary angiography revealed moderate stenosis with severe vasospasm. Despite treatment with vasodilators, the patient experienced persistent arrhythmias, necessitating multiple defibrillations. Coronary stenting of the affected arteries ultimately led to stabilization. This case highlights the challenges of managing refractory arrhythmias in VA and underscores the potential role of interventional therapy when medical management fails.

Downloads

Download data is not yet available.

References

1. Harris, J. R., Hale, G. M., Dasari, T. W., & Schwier, N. C. (2016). Pharmacotherapy of vasospastic angina. Journal of cardiovascular pharmacology and therapeutics, 21(5), 439-451.
2. He, Z., Xu, X., Zhao, Q., Ding, H., & Wang, D. W. (2023). Vasospastic angina: past, present, and future. Pharmacology & Therapeutics, 249, 108500.
3. Kaku, B., Honin, K., Horita, Y., Uno, Y., Yamazaki, T., Funada, A., & Ohka, T. (2005). The incidence of stent-edge spasm after stent implantation in patients with or without vasospastic angina pectoris. International Heart Journal, 46(1), 23-33.
4. Kawashima, S., & Yokoyama, M. (2004). Dysfunction of endothelial nitric oxide synthase and atherosclerosis. Arteriosclerosis, thrombosis, and vascular biology, 24(6), 998-1005.
5. Khatri, S., Webb, J. G., Carere, R. G., & Dodek, A. (2002). Stenting for coronary artery spasm. Catheterization and cardiovascular interventions, 56(1), 16-20.
6. Khiatah, B., Philips, D., Dukes, J., & Frugoli, A. (2020). Severe prinzmetal’s angina inducing ventricular fibrillation cardiac arrest. Case Reports in Cardiology, 2020(1), 3030878.
7. Kleyman, R., Goyal, R., Patel, N., Joseph, J., & Akel, R. (2019). Vasospastic angina and role of cardiac catheterization. Cureus, 11(9).
8. Kusama, Y., Kodani, E., Nakagomi, A., Otsuka, T., Atarashi, H., Kishida, H., & Mizuno, K. (2011). Variant angina and coronary artery spasm: the clinical spectrum, pathophysiology, and management. Journal of Nippon Medical School, 78(1), 4-12.
9. Lanza, G. A., & Shimokawa, H. (2023). Management of coronary artery spasm. European Cardiology Review, 18, e38.
10. Lee, H. C., Hong, S. R., Kim, H. S., Kim, K. C., Choi, W. H., Kang, M. K., ... & Lee, W. R. (2002). The risk factors of vasospastic angina. Korean Circulation Journal, 32(3), 224-232.
11. Lin, Z., Lin, X., Zhao, X., Xu, C., Yu, B., Shen, Y., & Li, L. (2022). Coronary artery spasm: risk factors, pathophysiological mechanisms and novel diagnostic approaches. Reviews in cardiovascular medicine, 23(5), 175.
12. Martí, V., Ligero, C., García, J., Kastanis, P., Guindo, J., & de Rozas, J. M. D. (2006). Stent implantation in variant angina refractory to medical treatment. Clinical Cardiology: An International Indexed and Peer‐Reviewed Journal for Advances in the Treatment of Cardiovascular Disease, 29(12), 530-533.
13. Mayer, S., & Hillis, L. D. (1998). Prinzmetal's variant angina. Clinical cardiology, 21(4), 243-246.
14. Ono, M., Okabe, T., Isomura, N., & Ochiai, M. (2024). Successful treatment of vasospastic angina refractory to various therapies using stenting: A case report. Journal of Cardiology Cases, 30(3), 97-100.
15. Picard, F., Sayah, N., Spagnoli, V., Adjedj, J., & Varenne, O. (2019). Vasospastic angina: a literature review of current evidence. Archives of cardiovascular diseases, 112(1), 44-55.
16. Rehan, R., Weaver, J., & Yong, A. (2022). Coronary vasospastic angina: a review of the pathogenesis, diagnosis, and management. Life, 12(8), 1124.
17. Saito, Y., Saito, Y., Kato, K., & Kobayashi, Y. (2022). Gender differences in factors associated with vasospastic angina. International Journal of Cardiology, 349, 7-11.
18. Song, J. K. (2018). Coronary artery vasospasm. Korean circulation journal, 48(9), 767.
19. Vanhoutte, P. M. (2003). Endothelial control of vasomotor function from health to coronary disease. Circulation journal, 67(7), 572-575.
20. Yoo, S. Y., & Kim, J. Y. (2009). Recent insights into the mechanisms of vasospastic angina. Korean circulation journal, 39(12), 505-511.
The European Scientific Journal (ESJ) ongoing call for papers
Published
2026-02-10
How to Cite
Gujejiani, L., Latsuzbaia, K., Tsivilashvili, J., Jalabadze, K., Kharebashvili, M., Jinjolia, N., Tetradze, V., & Taboridze, I. (2026). Prinzmetal Angina: A Case of Recurrent Ventricular Fibrillation. European Scientific Journal, ESJ, 50, 24. Retrieved from https://eujournal.org/index.php/esj/article/view/20626
Issue
Vol 50 (2026): ESI Preprints
Section
ESI Preprints

Copyright (c) 2026 Lali Gujejiani, Kakhaber Latsuzbaia, Jaba Tsivilashvili, Khatuna Jalabadze, Maia Kharebashvili, Nato Jinjolia, Vakhtang Tetradze, Iamze Taboridze

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.