Sudden Cardiac Arrest in a Young Male: The Role of Intraplaque Hemorrhage and Coronary Spasm.
Overview
abstract
BACKGROUND: Sudden cardiac death (SCD) is commonly linked to coronary artery disease (CAD), often involving plaque rupture or erosion. Intraplaque hemorrhage (IPH) has emerged as a significant factor in SCD. CASE SUMMARY: A 39-year-old man experienced intermittent chest pain before collapsing with ventricular fibrillation cardiac arrest. Coronary angiography revealed significant stenosis in the left anterior descending artery. Optical coherence tomography identified IPH. Coronary spasm was confirmed by acetylcholine testing. The patient was treated with percutaneous coronary intervention and long-term medical therapy including antiplatelet therapy and calcium channel blocker, with no adverse events over 3 years. DISCUSSION: This case underscores the importance of recognizing IPH and coronary spasm as contributors to SCD. Recent pathologic findings suggest a notable association between IPH and coronary spasm.
