ST-elevation in a patient with vasovagal syncope

Abstract

We describe a case of a 68-year-old man with known ischaemic heart disease, who passed out after nitroglycerine administration. He had triple-vessel ischaemic heart disease and had suffered from myocardial infarction about 17 years prior to this incident. An ECG revealed ST-segment elevation in the anterior leads. The elevations lasted at least 40 minutes and no longer than 60 minutes. No troponin I level elevation was detected in two subsequent blood samples. The probable causes of ST-segment elevation in this patient are discussed. In our opinion ST-segment elevation was caused by a combination of hypervagotonia and transient myocardial ischaemia.