Type 1 ST-segment elevation in the right precordial leads associated with acetylcholine-induced localized spasm of the conus branch of the right coronary artery

Abstract

A 61-year-old man with a history of frequent and early-morning episodes of chest pain was referred to our hospital for evaluation of coronary artery disease. He had no family history of Brugada syndrome or sudden cardiac death. Resting 12-lead electrocardiogram (ECG) showed no abnormality of ST-T wave. After admission, he underwent coronary angiography with written informed consent. The patient had no significant lesions of the major coronary artery and branches at baseline. Acetylcholine (ACh) injection into the left coronary artery induced coronary spasm in the proximal portion of the left anterior descending artery.