[Coronary artery spasms with normal coronary arteries as the cause of recurrent ventricular fibrillations].

Coronary arterial spasms are thought to be responsible for acute myocardial infarction in some patients with normal coronary arteries. A report is presented on a patient with a history of Prinzmetal angina pectoris involving ST-segment elevations in the electrocardiogram and recurrent ventricular fibrillation. Selective coronary arteriography revealed normal coronary arteries. Administration of nifedipin and isosorbide dinitrate brought about prompt relief of pain. One year after cardiac catheterization the patient developed recurrent ventricular arrhythmias when administration of nifedipin was discontinued. It is concluded that coronary arterial spasms may occur in patients with normal coronaries and may cause transient myocardial ischemia with severe ventricular arrhythmias. A history of Prinzmetal angina pectoris is usually present and medical treatment consists in administration of nifedipin and isosorbide dinitrate.