Spontaneous and Simultaneous Multivessel Coronary Spasm Causing Multisite Myocardial Infarction, Cardiogenic Shock, Atrioventricular Block, and Ventricular Fibrillation

A 57-year-old Taiwanese man with a past history of variant angina developed simultaneous anterior and inferior myocardial infarction, atrioventricular block, cardiogenic shock, and eventually ventricular fibrillation. Left coronary angiography revealed simultaneous Occlusion Of the left anterior descending and the left circumflex coronary arteries, which was relieved by intracoronary administration of isosorbide dinitrate. This is the first report of such a case in the English-language medical literature. (Circ J 2009; 73: 1961-1964)