Sudden cardiac death in a woman with clinical evidence of coronary vasospastic disease and myocardial stunning. A necrospy insight into the etiology

This case shed some light on the etiology of severe coronary vasospastic disease. A 54 years old lady with metabolic syndrome had a terminal ventricular fibrillation after an episode of acute ischemia caused by a coronary spasm. At the autopsy study an inflammatory perivascular and mainly perineural infiltration of the autonomic fibres of the cardiac nerves, confirmed at immunohistochemistry, could suggest a potential susceptibility of the nervous fibres to evoke an intense coronary vasospastic response as a consequence of non-specific events. Correspondence to: Carlo Caiati, Unità Operativa di Cardiologia Universitaria, Policlinico di Bari, Piazza G. Cesare, Italy, Tel: +39-080-5592750; Fax: +39-0805478796; E-mail: [email protected] Received: November 07, 2016; Accepted: December 05, 2016; Published: December 08, 2016 Background The etiology of vasospatic angina is not well known [1]. Coronary endodothelium and autonomic nerves dysfunction have been indicated as a possible mechanism of coronary vasospasm but these studies have had little clinical impact as no causes of this dysfunction if any, has been demonstrated [2-7].