Increasing pre-excitation (“concertina effect”) during vasospastic angina

A patient with Wolff-Parkinson-White syndrome and variant angina developed progressive ST-segment elevation in the inferior leads after hyperventilation-induced right coronary artery spasm. At the same time, increasing pre-excitation (“concertina effect”) developed with gradual prolongation of the A...

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Published inJournal of electrocardiology Vol. 19; no. 3; pp. 299 - 302
Main Authors Nakagawa, Susumu, Maeda, Kohichi, Imamura, Takuroh, Kondoh, Hiroyuki, Koiwaya, Yasushi, Tanaka, Kenjiro
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 1986
Subjects
Angina Pectoris, Variant - complications
Angina Pectoris, Variant - physiopathology
Atrioventricular Node - physiopathology
Coronary Vasospasm - complications
Coronary Vasospasm - physiopathology
Electrocardiography
Electrophysiology
Humans
Male
Middle Aged
Wolff-Parkinson-White Syndrome - complications
Wolff-Parkinson-White Syndrome - physiopathology
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Summary:A patient with Wolff-Parkinson-White syndrome and variant angina developed progressive ST-segment elevation in the inferior leads after hyperventilation-induced right coronary artery spasm. At the same time, increasing pre-excitation (“concertina effect”) developed with gradual prolongation of the AH interval on His bundle ECG. The ECG changes promptly disappeared after sublingual nitroglycerin, with termination of the chest pain. Transient ischemia induced by coronary artery spasm can be an etiology of increasing pre-excitation.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:0022-0736
1532-8430
DOI:10.1016/S0022-0736(86)80040-1