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.