Double hazards of ischemia and reperfusion arrhythmias in a patient with variant angina pectoris

•We presented the case of a 53 year-old male patient with recurrent episodes of chest pain.•The patient was diagnosed of variant angina pectoris.•Ischemia and reperfusion arrhythmia of this patient was detected by Holter when the episode attacked.•Ventricular fibrillation could be self-terminating without electric defibrillation or medical managements.

Variant angina pectoris, also called Prinzmetal's angina, is a syndrome caused by vasospasms of the coronary arteries. It can lead to myocardial infarction, ventricular arrhythmias, atrioventricular block and even sudden cardiac death. We report the case of a 53 year-old male patient with recurrent episodes of chest pain and arrhythmias in the course of related variant angina pectoris. It is likely that the reperfusion following myocardial ischemia was responsible for the ventricular fibrillation while the ST-segment returned to the baseline. This case showed that potential lethal arrhythmias could arise due to variant angina pectoris. It also indicated that ventricular fibrillation could be self-terminated.