Journal Article

Coronary spasm: a case of transient ST elevation and syncopal ventricular tachycardia without angina

Claudia Postorino, Mark M. Gallagher, Luca Santini, Giulia Magliano, Gaetano Chiricolo, Missiroli Bindo, Alfredo Postorino and Francesco Romeo

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 8, pages 568-570
Published in print August 2007 | ISSN: 1099-5129
Published online May 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eum087
Coronary spasm: a case of transient ST elevation and syncopal ventricular tachycardia without angina

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We report the case of a 60-year-old male with recurrent pre-syncope, referred with a provisional diagnosis of carotid sinus syndrome on the basis of a 4 s asystolic pause following carotid sinus massage. On repeat Holter monitoring there was ST-segment elevation followed by episodes of polymorphic ventricular tachycardia during a mild episode of pre-syncope. Coronary angiography showed mild right coronary artery irregularity without significant stenosis. An automatic cardioverter defibrillator was implanted and high dose combined vasodilator therapy was commenced. At follow-up 18 months after implantation, the device has recorded no episode of tachycardia and the patient reports no recurrence of symptoms.

Keywords: Coronary spasm; Sudden death; Ventricular tachycardia; Ventricular fibrillation; Syncope; Carotid sinus syndrome

Journal Article.  890 words.  Illustrated.

Subjects: Cardiovascular Medicine

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