Brugada syndrome-like ST-segment elevation increase exacerbated by vomiting

Circulation Journal : Official Journal of the Japanese Circulation Society
Mariko AraiFumihiko Miyake

Abstract

The patient was a 53 year-old male who had 3 syncopal episodes over a 6-month period. In the electrophysiological study, ventricular fibrillation (VF) was repeatedly induced by the ventricular extrastimulus method. Intravenous pilsicainide was administered, and the J-point and ST-segment in the right precordial leads became slightly elevated just following drug administration. Five min later, the patient experienced severe nausea and then vomited twice, at which point the electrocardiogram (ECG) showed increased elevation of the J-point and ST-segment. These ECG changes recovered to normal 30 min later. The cause of his syncope was strongly suspected to be related to the VF associated with Brugada syndrome. An interesting aspect of this case was the particular type of J-point and ST-segment elevation that was induced when the patient experienced nausea and vomiting. It is proposed that this phenomenon originated from the vagal stimulation associated with the nausea and vomiting.

References

Apr 1, 1996·Journal of the American College of Cardiology·T MiyazakiS Ogawa
Feb 6, 1999·Journal of the American College of Cardiology·I GussakB R Chaitman
Jun 16, 2001·Japanese Circulation Journal·H ItohUNKNOWN Hokuriku Brugada Study Group

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Citations

Aug 19, 2009·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Nicholas Theodotou, Joseph E Cillo
Dec 30, 2014·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Koichiro YoshiokaTeruhisa Tanabe
Aug 28, 2018·Frontiers in Physiology·Michelle M MonaskyLuigi Anastasia

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