Two cases of Brugada syndrome associated with spontaneous clinical episodes of coronary vasospasm

Abstract

Two patients with life-threatening episodes of ventricular fibrillation (VF) showed typical ST elevation in V1-V3 leads. Both had spontaneous clinical episodes of resting angina. Intracoronary injection of acetylcholine provoked coronary vasospasm and ST elevation was the same as Brugada-type ST elevation in 1 case but not in the other. Calcium channel antagonist was prescribed to prevent coronary vasospasm but Brugada-type ST elevation and the occurrence of VF could not be prevented. The symptoms accompanied both cases. Considering these cases, the pathogenesis of Brugada syndrome should differ from that of coronary vasospasm because it could not be prevented by calcium channel antagonist. © 2006 The Japanese Society of Internal Medicine.