Coronary spasm as a cause of sudden death induced by malignant ventricular arrhythmia

Coronary artery spasm is an uncommon presentation of angina and may be associated with other vasospastic diseases such as Raynaud’s disease. It is widely accepted that local imbalance of production and removal of nitric oxide (NO) and other endothelium-derived factors is generally responsible for the arterial spasm in variant angina. Very rarely, diffuse spasm can herald ventricular arrhythmias due to sudden reduction in perfusion.