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Open Date : 2019-07-08
3.49 MB
Author
Shinen, Toshiya
Ohira, Hiroshi
Description
An 80-year-old man was urgently transported because of unconsciousness. On admission, the chest electrocardiogram showed a negative T-wave; there was a high possibility of cardiac syncope. No disorder was detected on coronary angiography or on cardiac electrophysiological study. Although he was diagnosed as having coronary spastic angina, a loop recorder was implanted because syncope didn’t occur during acetylcholine load test. Syncope occurred again, a loop recorder detected increasing ST elevation and atrioventricular junctional rhythm without high infrequent pulse or tachyarrhythmia. Decreased blood pressure and syncope due to Bezold-Jarisch reflex with coronary vasospasm was strongly suspected. With benidipine and nicorandil, he was discharged without recurrence of syncope for 3 years thereafter.
Subject
syncope
coronary spastic angina
Bezold-Jarisch reflex
implantable loop recorder
calcium channel blocker
Journal information
Shimane Journal of Medical Science 36 ( 1 ), 23 - 28 , 2019-06
Publisher
Faculty of Medicine, Shimane University
Rights
Faculty of Medicine, Shimane University
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