Yamaki Masaru, Sato Nobuyuki, Myojo Takuya, Nishiura Takeshi, Nishimura Masato, Nakamura Hideki, Okada Motoi, Fujita Satoshi, Go Kazutomo, Sakamoto Naka, Tanabe Yasuko, Takeuchi Toshiharu, Kawamura Yuichiro, Hasebe Naoyuki
Department of Emergency Medicine, Asahikawa Medical College.
Int Heart J. 2010 Jan;51(1):68-71. doi: 10.1536/ihj.51.68.
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.
近期证据表明变异性心绞痛与Brugada综合征之间存在关联。在此我们报告两例冠状动脉疾病患者，他们出现了可能由右冠状动脉圆锥支缺血诱发或加重的心电图异常。这两例患者的12导联心电图显示为正常窦性心律。有趣的是，在右冠状动脉近端经皮腔内血管成形术过程中或向右冠状动脉内注射冠状动脉内乙酰胆碱（Ach）时，记录到V1-V3导联出现鞍背型或穹窿型ST段抬高。缺血改善后，这些Brugada型心电图改变恢复至基线心电图波形。在第二例中，右冠状动脉圆锥支痉挛与V1至V2导联的穹窿型ST段抬高有关。我们讨论了圆锥支病变所致缺血与Brugada型心电图改变之间可能的相互作用。
