Key result
Epinephrine, oral glucose, and acetylcholine provoke QTc prolongation and severe coronary spasm in LQTS.
Case Report (n=1)
This case highlights the rare coexistence of long QT syndrome and coronary vasospasm, suggesting important clinical implications for the management of LQTS.
May warrant caution with provocative testing in LQTS; leaves open whether vasospasm screening changes management.
A 20-year-old woman suffered from cardiopulmonary arrest due to ventricular fibrillation. The electrocardiogram after resuscitation showed prolonged QTc interval with bifid T wave. On the third hospital day, the QTc interval and the T-wave changes improved. However, the QTc interval was distinctively prolonged after administration of epinephrine, oral glucose load, and intracoronary acetylcholine (Ach) into the left coronary artery. Moreover, an injection of Ach into the right coronary artery provoked severe coronary spasm. This is a case of the coexistence of long QT syndrome (LQTS) and coronary vasospasm, which may give an important clinical implication for the treatment of LQTS.
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Tanaka et al. (2008) conducted a case report in Coexistence of long QT syndrome and coronary vasospasm (n=1). Epinephrine, oral glucose load, and intracoronary acetylcholine was evaluated on QTc interval prolongation and coronary spasm. Administration of epinephrine, oral glucose, and intracoronary acetylcholine provoked distinct QTc prolongation and severe coronary spasm in a 20-year-old woman with long QT syndrome.
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