A patient with recurrent syncope and ST-elevation on the electrocardiogram.
A 56-year old woman had over 100 episodes of syncope since the age of 8. Because the patient's description of the episodes suggested vasovagal syncope she was studied by a head up tilt test (HUT). Seconds after the uncomplicated HUT the patient experienced a typical syncope with bradycardia, marked ST-elevation and chest pain. After treatment with nifedipine she has had one syncopal spell in a follow up period of 31 months. We conclude that the syncopal events in this patient were caused by a combination of vasovagal syncope and coronary spasm.
Colman
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Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands. n.colman@amc.uva.nl
Wieling
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W
Wilde
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AA
D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003327:Coronary Disease / Q000175:diagnosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D012008:Recurrence; D013035:Spasm / Q000175:diagnosis; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000517:prevention & control; D018667:Tilt-Table Test
D002121:Calcium Channel Blockers; D009543:Nifedipine