Severe vasospastic angina with ventricular fibrillation suggested by iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid in a young woman.

Iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) imaging is useful to diagnose recent myocardial ischemia. A 27-year-old woman was admitted to our hospital because of aborted cardiac arrest due to ventricular fibrillation. She underwent BMIPP imaging in order to rule out ischemic heart disease. Reduced BMIPP uptake was observed in the inferoseptal segments. Coronary angiography revealed insignificant lesions, and a severe coronary spasm was provoked in the right coronary artery by an intracoronary injection of acetylcholine. The etiology of ventricular fibrillation in this case was considered to be vasospastic angina. The application of BMIPP imaging helped diagnose fatal vasospastic angina in this case.