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

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...

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Autores principales: Yang, Lu, Ma, Guodong, Yu, Tianyu, Gao, Huikuan, Wang, Yongliang, Wu, Yongquan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851773/
https://www.ncbi.nlm.nih.gov/pubmed/29489690
http://dx.doi.org/10.1097/MD.0000000000009900
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author Yang, Lu
Ma, Guodong
Yu, Tianyu
Gao, Huikuan
Wang, Yongliang
Wu, Yongquan
author_facet Yang, Lu
Ma, Guodong
Yu, Tianyu
Gao, Huikuan
Wang, Yongliang
Wu, Yongquan
author_sort Yang, Lu
collection PubMed
description 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.
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spelling pubmed-58517732018-03-21 A case report of Brugada-like ST-segment elevation probably due to coronary vasospasm Yang, Lu Ma, Guodong Yu, Tianyu Gao, Huikuan Wang, Yongliang Wu, Yongquan Medicine (Baltimore) 3400 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. Wolters Kluwer Health 2018-03-02 /pmc/articles/PMC5851773/ /pubmed/29489690 http://dx.doi.org/10.1097/MD.0000000000009900 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 3400
Yang, Lu
Ma, Guodong
Yu, Tianyu
Gao, Huikuan
Wang, Yongliang
Wu, Yongquan
A case report of Brugada-like ST-segment elevation probably due to coronary vasospasm
title A case report of Brugada-like ST-segment elevation probably due to coronary vasospasm
title_full A case report of Brugada-like ST-segment elevation probably due to coronary vasospasm
title_fullStr A case report of Brugada-like ST-segment elevation probably due to coronary vasospasm
title_full_unstemmed A case report of Brugada-like ST-segment elevation probably due to coronary vasospasm
title_short A case report of Brugada-like ST-segment elevation probably due to coronary vasospasm
title_sort case report of brugada-like st-segment elevation probably due to coronary vasospasm
topic 3400
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851773/
https://www.ncbi.nlm.nih.gov/pubmed/29489690
http://dx.doi.org/10.1097/MD.0000000000009900
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