Holter ECG diagnosis of nicotine-spray induced ventricular fibrillation. An unusual case of Prinzmetal variant angina.

N Tsianakas, S Bordignon, F Bologna, S Tohoku, S Chen, A Konstantinou, K R J Chun, B Schmidt

Journal of electrocardiology 2020 Nov - Dec

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We report on an interesting case of resuscitated sudden cardiac death (SDC) in a 51-year-old with hypertension and positive family history for SDC. The patient was resuscitated and an emergency angiogram ruled out coronary artery disease. Cardio-MRT ruled structural disease or infection. Holter and telemetry monitoring revealed premature ventricular complexes and transient ST-changes followed by anginaepisodes in correlation with the use of the nicotine-replacement-spray. The patient was urged to quit smoking and smoking-substitutes. Medical therapy with calcium-channelblocker and a long acting nitrate was administered. One-month follow up reported no arrhythmic or angina events. Copyright © 2020 Elsevier Inc. All rights reserved.

Citation

N Tsianakas, S Bordignon, F Bologna, S Tohoku, S Chen, A Konstantinou, K R J Chun, B Schmidt. Holter ECG diagnosis of nicotine-spray induced ventricular fibrillation. An unusual case of Prinzmetal variant angina. Journal of electrocardiology. 2020 Nov - Dec;63:17-20