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Acute Myocardial Injury and Complete Atrioventricular Block Induced by Transient Coronary Artery Spasm

A 65-year-old man with no previous history of heart disease presented with cardiogenic shock. Acute right ventricular failure following extensive inferior wall myocardial infarction and complete atrioventricular block were noted and emergent angiography revealed insignificant coronary arterial stenosis. In view of the finding and absence of myocardial vasculitis, coronary artery spasm was implicated as the cause of myocardial infarction and complete atrioventricular block. After the reversal of the shock and successful angioplasty, the patient continued to take lercanidipine and had been angina-free during follow-up of 5 months. (Hong Kong j.emerg.med. 2013;20:396-399)