title: Sudden death during Holter electrocardiogram monitoring in a patient with variant angina.
abstract: We report a case of sudden death due to variant angina during Holter electrocardiogram (ECG) monitoring. The patient, a 60-year-old man, had been aware of chest discomfort lasting less than one minute at midnight 2 days earlier. Because variant angina or arrhythmia was suspected, Holter ECG monitoring was performed. The patient spent a whole day without a recurrence of chest pain before going to bed, but at midnight he developed sudden chest pain, and died immediately after taking a sublingual tablet of isosorbide-dinitrite. Analysis of the Holter ECG revealed ventricular fibrillation after several ventricular premature beats following ST-segment elevation in both the CM5 and NASA leads. This case shows that sudden death from variant angina may occur within a few days after the first onset, and also highlights whether priority should be given to making a definite diagnosis or giving treatment when variant angina is strongly suspected.
authors.affiliation: Division of Cardiology, Shinkyo Hospital, Kagoshima.
authors.forename: T
authors.initials: T
authors.lastname: Tsurukawa
authors.forename: K
authors.initials: K
authors.lastname: Kawabata
authors.forename: K
authors.initials: K
authors.lastname: Miyahara
authors.forename: R
authors.initials: R
authors.lastname: Kawano
authors.forename: H
authors.initials: H
authors.lastname: Sohara
authors.forename: S
authors.initials: S
authors.lastname: Amitani
authors.forename: M
authors.initials: M
authors.lastname: Kurose
mesh_terms: D000788:Angina Pectoris, Variant / Q000150:complications* / Q000503:physiopathology; D003645:Death, Sudden / Q000209:etiology*; D015716:Electrocardiography, Ambulatory; D006801:Humans; D008297:Male; D008875:Middle Aged; D014693:Ventricular Fibrillation / Q000209:etiology; D018879:Ventricular Premature Complexes / Q000209:etiology