title: Coronary spasm: a case of transient ST elevation and syncopal ventricular tachycardia without angina.
abstract: 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.
authors.affiliation: Dipartimento di Cardiologia, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Postorino
authors.forename: Mark M
authors.initials: MM
authors.lastname: Gallagher
authors.forename: Luca
authors.initials: L
authors.lastname: Santini
authors.forename: Giulia
authors.initials: G
authors.lastname: Magliano
authors.forename: Gaetano
authors.initials: G
authors.lastname: Chiricolo
authors.forename: Missiroli
authors.initials: M
authors.lastname: Bindo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Postorino
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
mesh_terms: D000789:Angina, Unstable / Q000175:diagnosis / Q000517:prevention & control; D003329:Coronary Vasospasm / Q000175:diagnosis* / Q000517:prevention & control*; D004554:Electric Countershock; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000517:prevention & control*; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000517:prevention & control*; D016896:Treatment Outcome