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A Murine Closed-chest Model of Myocardial Ischemia and Reperfusion
13:42

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Published on: July 17, 2012

[One patient - many faces of myocardial ischaemia]

Barbara Uznańska-Loch1, Urszula Cieślik-Guerra, Tomasz Rechciński

  • 1Medical University of Łódź, Łódź, Poland. tyhe@op.pl

Kardiologia Polska
|June 26, 2013
PubMed

Insights

A patient experienced recurrent chest pain and syncope after coronary angioplasty for myocardial infarction. Variant angina and atrioventricular block were diagnosed, necessitating pacemaker implantation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Electrophysiology

Background:

  • A patient underwent coronary angioplasty for non-ST segment elevation myocardial infarction.
  • Recurrence of symptoms led to a second angioplasty due to restenosis.

Observation:

  • The patient continued to experience chest pain and syncope despite interventions.
  • Holter electrocardiogram monitoring revealed atrioventricular block.
  • ST-segment elevations were noted in conjunction with the atrioventricular block.

Findings:

  • Variant angina was diagnosed as the underlying cause of the patient's symptoms.
  • Medical management for variant angina and atrioventricular block proved insufficient.
  • Pacemaker implantation was ultimately required to manage the cardiac condition.

Implications:

  • This case highlights the complex interplay between coronary artery disease, variant angina, and conduction abnormalities.
  • It underscores the importance of thorough diagnostic evaluation, including Holter monitoring, in patients with refractory chest pain.
  • The necessity of pacemaker implantation in select cases of variant angina with atrioventricular block is demonstrated.

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