Cardiology - Case Reports
May 20, 2020
Vol. 90 No. 2 (2020)
ST-elevation during head up tilt test: a challenging case in syncope unit
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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A 65-year-old woman, during an elective head up tilt test, after the sublingual nitrate administration, experienced electrocardiogram alteration with ST elevation in the inferior leads, that returned normal when the patient was laid supine after few minutes. Serial cardiac markers were not elevated and coronary angiography revealed normal epicardial coronary arteries. Paradoxical vasospastic response to nitrates in vasospastic angina patients represents a rare but very challenging condition and the best therapeutic approach in this subgroup of patients remains unclear.
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“ST-Elevation During Head up Tilt Test: A Challenging Case in Syncope Unit”. 2020. Monaldi Archives for Chest Disease 90 (2). https://doi.org/10.4081/monaldi.2020.1271.