Diffuse triple-vessel coronary spasm as a cause of asystole and syncope

Vasospasm plays an important role in the pathogenesis of ischemic heart disease, including unstable angina, myocardial infarction, and sudden death. Coronary artery spasm rarely involves different coronaries in the same time. Three-vessel spasm may be accompanied by ST-segment elevation, lethal arrhythmias, and syncope due to the wide extent of ischemia. In the present case, a patient with syncope secondary to documented diffuse vasospasm involving 3 major coronary arteries was reported. This case report indicated that in case of unexplained syncope, asystole secondary to coronary artery spasm should be considered as a possible cause.