Possible Contribution of Ischemia of the Conus Branch to Induction or Augmentation of Brugada Type Electrocardiographic Changes in Patients With Coronary Artery Disease

• Yamaki Masaru

  Department of Emergency Medicine, Asahikawa Medical College

• Sato Nobuyuki

  Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College

• Myojo Takuya

  Department of Cardiovascular Medicine, Abashiri Kohsei General Hospital

• Nishiura Takeshi

  Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College

• Nishimura Masato

  Department of Cardiovascular Medicine, Abashiri Kohsei General Hospital

• Nakamura Hideki

  Department of Cardiovascular Medicine, Abashiri Kohsei General Hospital

• Okada Motoi

  Department of Emergency Medicine, Asahikawa Medical College

• Fujita Satoshi

  Department of Emergency Medicine, Asahikawa Medical College

• Go Kazutomo

  Department of Emergency Medicine, Asahikawa Medical College

• Sakamoto Naka

  Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College

• Tanabe Yasuko

  Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College

• Takeuchi Toshiharu

  Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College

• Kawamura Yuichiro

  Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College

• Hasebe Naoyuki

  Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College

Abstract

Recent evidence suggests an association between vasospastic angina and Brugada syndrome. Here we present two cases of coronary artery disease who presented with ECG abnormalities which might have been provoked or enhanced by ischemia of the conus branch of the right coronary artery. The 12-lead ECGs demonstrated normal sinus rhythm in these two cases. Interestingly, a saddle back or coved type ST segment elevation in leads V1-V3 was documented either in the percutaneous transluminal angioplasty procedure of the proximal right coronary artery or with an intracoronary acetylcholine (Ach) administration into the right coronary artery. These Brugada type ECG changes were restored to the baseline ECG waveform after improvement in the ischemia. In the second case, vasospasms of the conus branch of the right coronary artery were associated with a coved type ST segment elevation in leads V1 to V2. We discuss the possible interaction between ischemia caused by conus branch lesions and Brugada type electrocardiographic changes.

Journal

• International Heart Journal

  International Heart Journal 51 (1), 68-71, 2010

  International Heart Journal Association

Keywords

• Brugada type ECG
• Conus branch
• Ischemia

Details

• CRID: 1390001205227096320
• NII Article ID: 130000162399
• DOI: 10.1536/ihj.51.68
• ISSN: 13493299
• ISSN: 13492365
• Web Site: http://www.jstage.jst.go.jp/article/ihj/51/1/51_1_68/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2010180297
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed