Abstract:Objective To describe the diagnosis,treatment and possible mechanism of cardiac shock caused by diffuse multi-vessel coronary artery spasm. Methods A retrospective analysis was made on the clinical data of one patient with a sudden onset and persistent retrosternal chest pain for 30 minutes,leading to ventricular fibrillation and cardiogenic shock on May 31,2018,who underwent left anterior descending coronary artery and the first diagonal branch stent implantation 4 years ago. Results The patient was successfully rescued by antishock drugs,defibrillation,emergency coronary angiography (CAG),intracoronary injection of antispasmodic drugs,intra-aortic balloon counterpulsation and was in stable condition one week later. The previous history and the comparison of CAG and intravascular ultrasound showed that the sudden ventricular fibrillation and cardiogenic shock were caused by the progression of spasm of single right coronary artery and left anterior descending branch to diffuse spasm of multiple coronary arteries. Conclusion Diffuse multi-vessel coronary artery spasm is an uncommon cause of cardiogenic shock.