A patient with recurrent syncope and ST-elevation on the electrocardiogram
N Colman1, W Wieling, A A M Wilde
1Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands. n.colman@amc.uva.nl
Abstract:
A 56-year old woman had over 100 episodes of syncope since the age of 8. Because the patient's description of the episodes suggested vasovagal syncope she was studied by a head up tilt test (HUT). Seconds after the uncomplicated HUT the patient experienced a typical syncope with bradycardia, marked ST-elevation and chest pain. After treatment with nifedipine she has had one syncopal spell in a follow up period of 31 months. We conclude that the syncopal events in this patient were caused by a combination of vasovagal syncope and coronary spasm.
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