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A case report of Brugada-like ST-segment elevation probably due to coronary vasospasm.

Abstract Vasospastic angina is caused by sudden occlusive vasoconstriction of a segment of an epicardial artery, with transient ST-segment elevation on electrocardiography. Brugada Syndrome is an inherited arrhythmogenic cardiac disorder with a diagnostic electrocardiography characterized by coved-type ST-segment elevation in right precordial leads (V1-V3). Those two diseases usually have no correlation. In this report, we discuss an interesting case of a patient who was diagnosed as vasospastic angina according to his coronary angiography, but his electrocardiography showed a Brugada-like ST-segment elevation.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29489690
OWN - NLM
STAT- MEDLINE
DCOM- 20180307
LR  - 20180307
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 9
DP  - 2018 Mar
TI  - A case report of Brugada-like ST-segment elevation probably due to coronary
      vasospasm.
PG  - e9900
LID - 10.1097/MD.0000000000009900 [doi]
AB  - RATIONALE: Vasospastic angina is caused by sudden occlusive vasoconstriction of a
      segment of an epicardial artery, with transient ST-segment elevation on
      electrocardiography. Brugada Syndrome is an inherited arrhythmogenic cardiac
      disorder with a diagnostic electrocardiography characterized by coved-type
      ST-segment elevation in right precordial leads (V1-V3). Those two diseases
      usually have no correlation. In this report, we discuss an interesting case of a 
      patient who was diagnosed as vasospastic angina according to his coronary
      angiography, but his electrocardiography showed a Brugada-like ST-segment
      elevation. PATIENT CONCERNS: Our patient had a 9-month history of temporary but
      progressive substernal burning sensation with acid bilges of shoulders and arms, 
      as well as profuse sweating at night. DIAGNOSES: Although he had no abnormal
      laboratory test result, no dysfunctional recorded echocardiogram or documented
      arrhythmia after being admitted to the hospital, his electrocardiography showed a
      Brugada-like ST-segment elevation. The coronary angiography result confirmed a
      diagnosis of vasospastic angina. INTERVENTIONS: The patient was prescribed
      diltiazem, aspirin, isosorbide mononitrate and rosuvastatin and was strongly
      advised to quit cigarettes and alcohol. OUTCOMES: Follow-up at half a year turned
      out well. LESSONS: This case links Brugada syndrome to coronary vasospasm. They
      may share similar mechanisms. Provocation test and gene test needs to be ran to
      distinguish both. Long-term follow-up is essential for it may bring a warning
      sign for life threatening ventricular arrhythmias.
FAU - Yang, Lu
AU  - Yang L
AD  - Department of Cardiology, Beijing Friendship Hospital.
FAU - Ma, Guodong
AU  - Ma G
AD  - Department of Cardiology, Beijing Friendship Hospital.
FAU - Yu, Tianyu
AU  - Yu T
AD  - Department of Cardiology, Beijing Friendship Hospital.
FAU - Gao, Huikuan
AU  - Gao H
AD  - Department of Cardiology, Beijing Friendship Hospital.
FAU - Wang, Yongliang
AU  - Wang Y
AD  - Department of Cardiology, Beijing Friendship Hospital.
FAU - Wu, Yongquan
AU  - Wu Y
AD  - Department of Cardiology, Beijing Friendship Hospital.
AD  - Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease,
      Beijing, China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Angina Pectoris/*complications/diagnostic imaging
MH  - Brugada Syndrome/diagnostic imaging/*etiology
MH  - Coronary Angiography
MH  - Coronary Vasospasm/*complications/diagnostic imaging
MH  - Electrocardiography
MH  - Humans
MH  - Male
EDAT- 2018/03/01 06:00
MHDA- 2018/03/08 06:00
CRDT- 2018/03/01 06:00
PHST- 2018/03/01 06:00 [entrez]
PHST- 2018/03/01 06:00 [pubmed]
PHST- 2018/03/08 06:00 [medline]
AID - 10.1097/MD.0000000000009900 [doi]
AID - 00005792-201803020-00051 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Mar;97(9):e9900. doi: 10.1097/MD.0000000000009900.