Fainting after chest pain

Ko Fan Wang, Chun Chin Chang, Chien Yi Hsu, Ching Wei Lee, Chung Hsing Lin, Chern En Chiang

Research output: Contribution to journalArticle

Abstract

Variant angina presenting acute chest pain and ST elevation on electrocardiogram accounts for an underdiagnosed scenario in acute coronary syndrome and contributes to syncope as a consequence of ventricular arrhythmia. Here,we report a case of a 48-year-old manwith a recent onset of chest pain and palpitations followed by syncope. Holter monitoring documented 2 episodes of evolving ST elevation associated with non-sustained ventricular tachycardia. Emergent cardiac catheterization indicated insignificant coronary narrowing. A non-invasive brachial artery ultrasound, which demonstrated endothelial dysfunction that was salvaged by exogenic nitrate, was used instead of intracoronary provocation. There was no clinical or electrocardiographic recurrence of variant angina after vasodilator treatment. In conclusion, variant angina represents an important but overlooked etiology for syncope. Holter monitoring facilitates the diagnostic and prognostic assessment in patients with syncope precipitated by chest pain.

Original languageEnglish
Pages (from-to)215-225
Number of pages11
JournalActa Cardiologica Sinica
Volume31
Issue number3
DOIs
Publication statusPublished - Jan 1 2015
Externally publishedYes

Fingerprint

Syncope
Chest Pain
Ambulatory Electrocardiography
Brachial Artery
Acute Pain
Acute Coronary Syndrome
Ventricular Tachycardia
Cardiac Catheterization
Vasodilator Agents
Nitrates
Cardiac Arrhythmias
Electrocardiography
Recurrence
Therapeutics

Keywords

  • Flow-mediated vasodilation
  • Holter monitoring
  • Variant angina
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Wang, K. F., Chang, C. C., Hsu, C. Y., Lee, C. W., Lin, C. H., & Chiang, C. E. (2015). Fainting after chest pain. Acta Cardiologica Sinica, 31(3), 215-225. https://doi.org/10.6515/ACS20141124A

Fainting after chest pain. / Wang, Ko Fan; Chang, Chun Chin; Hsu, Chien Yi; Lee, Ching Wei; Lin, Chung Hsing; Chiang, Chern En.

In: Acta Cardiologica Sinica, Vol. 31, No. 3, 01.01.2015, p. 215-225.

Research output: Contribution to journalArticle

Wang, KF, Chang, CC, Hsu, CY, Lee, CW, Lin, CH & Chiang, CE 2015, 'Fainting after chest pain', Acta Cardiologica Sinica, vol. 31, no. 3, pp. 215-225. https://doi.org/10.6515/ACS20141124A
Wang KF, Chang CC, Hsu CY, Lee CW, Lin CH, Chiang CE. Fainting after chest pain. Acta Cardiologica Sinica. 2015 Jan 1;31(3):215-225. https://doi.org/10.6515/ACS20141124A
Wang, Ko Fan ; Chang, Chun Chin ; Hsu, Chien Yi ; Lee, Ching Wei ; Lin, Chung Hsing ; Chiang, Chern En. / Fainting after chest pain. In: Acta Cardiologica Sinica. 2015 ; Vol. 31, No. 3. pp. 215-225.
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