Pilsicainide-induced coronary vasospasm in a patient with Brugada-type electrocardiogram.
A 65-year-old man with Brugada-type electrocardiogram (ECG) was admitted to our hospital for chest pain, palpitation and faintness. In the cardiac electrophysiological study, no ventricular tachyarrthymia was induced either at baseline or after pilsicainide (50 mg) infusion. Intravenous administration of pilsicainide exaggerated ST-segment elevation in V(1-4) and converted it to the coved type in V(1), accompanied by severe chest pain. Coronary angiography revealed the vasospasm of the right coronary artery was induced by pilsicainide, not by ergonovine. This is the first case report of coronary vasospasm induced by a pure sodium channel blocker in a patient with Brugada-type ECG.
The Cardiovascular Institute, Tokyo Medical and Dental University, Tokyo, Japan. goda@cvi.or.jp
Ayumi
A
Goda
Takeshi
T
Yamashita
Takeshi
T
Kato
Akira
A
Koike
Kouichi
K
Sagara
Hajime
H
Kirigaya
Haruki
H
Itoh
Tadanori
T
Aizawa
Long-Tai
LT
Fu
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000000981:diagnostic imaging; D004562:Electrocardiography; D006323:Heart Arrest / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide