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

Abstract:

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.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Yang L,Ma G,Yu T,Gao H,Wang Y,Wu Y

doi

10.1097/MD.0000000000009900

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

e9900

issue

9

eissn

0025-7974

issn

1536-5964

pii

00005792-201803020-00051

journal_volume

97

pub_type

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