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Europace 2004 6(4):296-300; doi:10.1016/j.eupc.2004.03.003
© 2004 by European Society of Cardiology
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CASE REPORT

A patient with recurrent syncope and ST-elevation on the electrocardiogram

N. Colmana,*, W. Wielingb and A.A.M. Wildea

aDepartment of Cardiology, Academic Medical Centre Amsterdam, The Netherlands; bDepartment of Internal Medicine, Academic Medical Centre Amsterdam, The Netherlands

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.

Key Words: syncope, ST-elevation, coronary spasm, hyperventilation

*Corresponding author. Academic Medical Centre, Meibergdreef 9, F4-222 1105 AZ Amsterdam, The Netherlands. Tel.: +31-20-5669111. E-mail address: n.colman{at}amc.uva.nl (N. Colman).


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