title: Do not put money where your mouth is!
abstract: 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.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Natasja M S
authors.initials: NM
authors.lastname: de Groot
authors.forename: Arthur J H A
authors.initials: AJ
authors.lastname: Scholte
authors.forename: Monique R M
authors.initials: MR
authors.lastname: Jongbloed
authors.forename: Joanne D
authors.initials: JD
authors.lastname: Schuijf
authors.forename: Marco C
authors.initials: MC
authors.lastname: DeRuiter
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
mesh_terms: 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