Coronary spasm: a case of transient ST elevation and syncopal ventricular tachycardia without angina.
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.
Postorino
Claudia
C
Dipartimento di Cardiologia, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy.
Gallagher
Mark M
MM
Santini
Luca
L
Magliano
Giulia
G
Chiricolo
Gaetano
G
Bindo
Missiroli
M
Postorino
Alfredo
A
Romeo
Francesco
F
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