Huge ST elevation and ventricular arrhythmias in vasospastic angina diagnosed by Holter monitoring

摘要

We report a case of a 67 year old man with a recent history of sporadic chest pain and palpitations. After a normal, maximal stress test he underwent 24-hours Holter monitoring that showed two short periods of huge ST segment elevation associated with non sustained ventricular tachycardia and chest pain, referable to coronary spasm. Coronary angiogram showed significant atherosclerotic stenosis in the right coronary artery treated by angioplasty and bare metal stent implantation. Holter monitoring is a non-invasive and low-cost examination that can give valuable informations; it should be reserved for selected patients when vasospastic angina is suspected.