Silent and malignant early repolarization syndrome mimicking hyper-acute ST elevation myocardial infarction

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3 Citations (Scopus)

Abstract

A 55-year-old male with underlying type 2 diabetes mellitus and hypertension presented at our emergency department with ventricular fibrillation-related cardiac arrest. Hyper-acute ST elevationmyocardial infarction was the preliminary diagnosis by 12-lead electrocardiography, which simultaneously showed J point ST elevation and tall T waves. However, the echocardiography showed concentric left ventricle hypertrophy and preserved left ventricular systolic function with no regional wall motion abnormalities, and coronary angiography did not show any critical coronary artery lesion. Malignant early repolarization syndrome was diagnosed, and an implantable cardioverter defibrillator was implanted. Early repolarization syndrome is associated with J point elevation, and more involved leads and an increased J point elevation amplitude can increase the risk of arrhythmogenicity. In summary,we report a case with asymptomatic type 3 early repolarization syndrome-induced idiopathic ventricular fibrillation mimicking hyper-acute ST elevation myocardial infarction.

Original languageEnglish
Pages (from-to)506-510
Number of pages5
JournalActa Cardiologica Sinica
Volume32
Issue number4
DOIs
Publication statusPublished - Jul 1 2016

Fingerprint

Implantable Defibrillators
Ventricular Fibrillation
Heart Arrest
Coronary Angiography
Left Ventricular Function
Type 2 Diabetes Mellitus
Infarction
Hypertrophy
Heart Ventricles
Echocardiography
Hospital Emergency Service
Coronary Vessels
Electrocardiography
Hypertension
ST Elevation Myocardial Infarction
Paroxysmal ventricular fibrillation
Lead

Keywords

  • Early repolarization
  • Idiopathic ventricular fibrillation
  • J wave syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Silent and malignant early repolarization syndrome mimicking hyper-acute ST elevation myocardial infarction",
abstract = "A 55-year-old male with underlying type 2 diabetes mellitus and hypertension presented at our emergency department with ventricular fibrillation-related cardiac arrest. Hyper-acute ST elevationmyocardial infarction was the preliminary diagnosis by 12-lead electrocardiography, which simultaneously showed J point ST elevation and tall T waves. However, the echocardiography showed concentric left ventricle hypertrophy and preserved left ventricular systolic function with no regional wall motion abnormalities, and coronary angiography did not show any critical coronary artery lesion. Malignant early repolarization syndrome was diagnosed, and an implantable cardioverter defibrillator was implanted. Early repolarization syndrome is associated with J point elevation, and more involved leads and an increased J point elevation amplitude can increase the risk of arrhythmogenicity. In summary,we report a case with asymptomatic type 3 early repolarization syndrome-induced idiopathic ventricular fibrillation mimicking hyper-acute ST elevation myocardial infarction.",
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T1 - Silent and malignant early repolarization syndrome mimicking hyper-acute ST elevation myocardial infarction

AU - Tam, Weng Chio

AU - Hsieh, Ming Hsiung

AU - Lin, Yung Kuo

AU - Yeh, Jong Shiuan

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N2 - A 55-year-old male with underlying type 2 diabetes mellitus and hypertension presented at our emergency department with ventricular fibrillation-related cardiac arrest. Hyper-acute ST elevationmyocardial infarction was the preliminary diagnosis by 12-lead electrocardiography, which simultaneously showed J point ST elevation and tall T waves. However, the echocardiography showed concentric left ventricle hypertrophy and preserved left ventricular systolic function with no regional wall motion abnormalities, and coronary angiography did not show any critical coronary artery lesion. Malignant early repolarization syndrome was diagnosed, and an implantable cardioverter defibrillator was implanted. Early repolarization syndrome is associated with J point elevation, and more involved leads and an increased J point elevation amplitude can increase the risk of arrhythmogenicity. In summary,we report a case with asymptomatic type 3 early repolarization syndrome-induced idiopathic ventricular fibrillation mimicking hyper-acute ST elevation myocardial infarction.

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