The head-up tilt test -- a cause of myocardial infarction.
INFARCTION: A 74-year-old man with no known ischaemic heart disease presented to the Cardiology Department with a history of multiple episodes of pre-syncope. During a head-up tilt test to investigate a neurocardiogenic cause, after glyceryl trinitrate provocation he became profoundly hypotensive and unwell. Subsequent ECGs and Troponin-T levels confirmed a Non ST-Elevation Myocardial Infarction. Angiography confirmed coronary artery disease. This case highlights a rare complication of tilt testing and emphasises that the test is not without risk.
Goolamali
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Cardiology Department, St George's Hospital, Blackshaw Road, Tooting, London SW17 OQT, United Kingdom. mediderm@btinternet.com
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D000368:Aged; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology*; D005996:Nitroglycerin; D018667:Tilt-Table Test / Q000009:adverse effects*; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D005996:Nitroglycerin