ST-T wave changes in a patient complicated with vasospastic angina and Brugada syndrome: differential responses to acetylcholine in right and left coronary artery.
A 49-year-old man with chest pain and syncope presented saddleback or occasionally coved type ST elevation in V1-V3. Coronary spasm in the left anterior descending artery was induced by acetylcholine injection and ST elevation changed from saddleback to coved type in V2-V3 together with ST depression in V4-V5, whereas acetylcholine injection into the right coronary artery did not provoke spasm, but induced augmented and coved type ST elevation in V2 without ST-T changes in V4-V5. These electrocardiographic changes in response to acetylcholine administration into each coronary artery are compatible with pathogenesis of vasospastic angina and Brugada syndrome, respectively.
Nishizaki
Mitsuhiro
M
Department of Cardiology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuura-Higashi, Kanazawa-ku, Yokohama 236-0037, Japan. nisizaki@yhb.att.ne.jp
Fujii
Hiroyuki
H
Ashikaga
Takashi
T
Yamawake
Noriyoshi
N
Sakurada
Harumizu
H
Hiraoka
Masayasu
M
D000109:Acetylcholine; D000788:Angina Pectoris, Variant / Q000209:etiology* / Q000503:physiopathology; D053840:Brugada Syndrome / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications* / Q000503:physiopathology; D003331:Coronary Vessels / Q000187:drug effects* / Q000503:physiopathology; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000209:etiology / Q000503:physiopathology; D014661:Vasoconstriction / Q000187:drug effects*; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
D000109:Acetylcholine