Characteristics of patients with cardiac arrest caused by coronary vasospasm.

BACKGROUND: Although coronary vasospasm (CVS) would be one of the major causes of out-of-hospital cardiac arrest (OHCA), the characteristics of patients with cardiac arrest caused by CVS have not been clarified.

METHODS AND RESULTS: In study 1, 1,000 consecutive patients with OHCA were retrospectively categorized based on the cause of OHCA, and the prevalence of CVS OHCA was elucidated. In study 2, 138 consecutive CVS patients were divided into 2 groups: CVS with cardiac arrest (arrest-CVS, n=12) and CVS without cardiac arrest (non-arrest-CVS, n=126). In study 1, 589 patients had OHCA caused by cardiovascular disease and 121 patients were successfully resuscitated. Among the 121 resuscitated patients, 9 had CVS OHCA. In study 2, the incidence of cardiac events (ie, cardiac arrest or chest pain) occurring on vigorous exertion, in the daytime and without prodromal chest symptoms was higher in the arrest-CVS group than in the non-arrest-CVS group.

CONCLUSIONS: CVS is an important cause of OHCA. Because significantly different characteristics are observed between CVS patients with cardiac arrest and those without, care should be taken to diagnose CVS as the cause of cardiac arrest.