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Crit Care Resusc. 2010 Dec;12(4):269-72.

An unusual case of pulseless electrical activity arrest associated with Prinzmetal's angina.

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Department of Intensive Care, Gold Coast Hospital, Southport, QLD.


Cardiac arrest due to ventricular tachyrhythmia in the setting of Prinzmetal's angina (PA) has been well reported in the literature. However, to our knowledge, there have been no reports of a pulseless electrical activity (PEA) arrest in patients with PA. We report a case of PEA arrest in a patient with PA after surgical drainage of an abscess in the first web-space of the left hand. We propose that the Bezold-Jarisch reflex may be the underlying mechanism responsible for this arrest. The case also highlights the danger of ceasing treatment with nitrates and calcium channel blockers in patients with PA.

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