Sudden cardiac arrest and syncope triggered by coronary spasm

Ikuko Togashi, Toshiaki Sato, Kyoko Soejima, Seiji Takatsuki, Shunichiro Miyoshi, Kotaro Fukumoto, Nobuhiro Nishiyama, Masaru Suzuki, Shingo Hori, Satoshi Ogawa, Keiichi Fukuda

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Background: Patients with coronary spasm generally have a good prognosis, although it can result in sudden cardiac arrest (SCA) and syncope. We hypothesized that the nature of coronary spasm triggering lethal arrhythmias may be different from that which induces angina-only. Methods: Clinical characteristics were examined in patients who had experienced SCA (n = 18) or syncope (n = 28) triggered by coronary spasm. These characteristics were compared to those of patients who had coronary spastic angina-only (n = 52). Results: SCA and syncope occurred frequently during daytime in 57% and 68%, respectively. Spontaneous ST-segment changes during daytime were recorded more often in patients with SCA (50%) and syncope (39%) than angina-only patients (4%, p < 0.01 for each). Nocturnal angina occurred less frequently in patients with SCA (33%) and syncope (32%) than angina-only patients (83%, p < 0.01 for each). Severe multivessel spasm, daytime ST-segment changes, and younger age were significant predictors of SCA. Daytime ST-segment changes and active smoking were related to syncope. Conclusions: The circadian variance of coronary spasm triggering SCA or syncope may be different from that inducing typical coronary spastic angina. The coronary spasm should be evaluated for patients with aborted SCA or recurrent syncope of unknown cause, even though the patients have not experienced the typical nocturnal angina.

Original languageEnglish
Pages (from-to)56-60
Number of pages5
JournalInternational Journal of Cardiology
Issue number1
Publication statusPublished - 2013 Feb 10


  • Coronary spasm
  • Sudden cardiac arrest
  • Syncope

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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