Do not put money where your mouth is!
A 60-year-old woman presented with repolarization disorders on the electrocardiogram after a generalized seizure, which immediately disappeared after vomiting up a 20-eurocent coin. We did not find any evidence of coronary artery disease. Multislice computed tomography demonstrated no coronary atherosclerotic stenosis but a close relationship of the esophagus with the coronary arteries. This relation was further studied in detail in a human cadaver. From our findings, it is most likely that the electrocardiogram alterations were due to compression of the ramus descendens posterior of the right coronary artery and/or the ramus circumflexus of the left coronary artery by the coin.
de Groot
Natasja M S
NM
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Scholte
Arthur J H A
AJ
Jongbloed
Monique R M
MR
Schuijf
Joanne D
JD
DeRuiter
Marco C
MC
Bax
Jeroen J
JJ
Schalij
Martin J
MJ
D017023:Coronary Angiography; D004562:Electrocardiography; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009055:Mouth; D012640:Seizures / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology