Sudden cardiac death during Holter recording in a patient with vasospastic angina

Rest angina with transient ST segment elevation is the more frequent clinical presentation of coronary vasospasm. However, ventricular arrhythmias may be triggered by vasospasm episodes or reperfusion phenomenon, being vasospastic angina a rare but possible cause of sudden cardiac death in patients with structurally normal heart. We report of a patient admitted to the hospital presenting with recurrent nonexertional substernal chest pain who experienced an episode of sudden cardiac death due to malignant ventricular arrhythmias during a 24-hour Holter ECG.