Coronary artery spasm is sometimes associated with life-threatening ventricular arrhythmias. Based on intravascular ultrasound findings, it appears that coronary artery spasm promotes negative arterial remodeling, suggesting that patients with coronary artery spasm might be at higher risk of accelerated coronary atherosclerosis. We report the cases of 3 patients with ventricular arrhythmia secondary to coronary artery spasm complicated by accelerated coronary atherosclerosis. Consequently, coronary disease progression should be considered in the case of angina pectoris recurrence in patients with coronary artery spasm, especially in those with coronary artery spasm complicated by ventricular arrhythmia.
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