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Korean J Med > Volume 89(1); 2015 > Article
The Korean Journal of Medicine 2015;89(1): 79-84.
관상동맥 연축에 의하여 발생한 발작성심방세동과 동서맥 1예
배강남, 황병희, 이관용, 정성민
가톨릭대학교 의과대학 내과학교실
A Case of Paroxysmal Atrial Fibrillation and Sinus Bradycardia due to Coronary Artery Spasm
Kang Nam Bae, Byung Hee Hwang, Kwan Yong Lee, Sung Min Jung
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding Author: Byung Hee Hwang ,Tel: +82-2-958-2475, Fax: +82-2-968-7250, Email: hbhmac@naver.com
Received: October 7, 2014;   Revised: October 13, 2014;   Accepted: October 30, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Paroxysmal atrial fibrillation may be induced by coronary spasm presenting with typical angina-like pain and palpitations. It is typically treated using rate or rhythm control strategies, although sustained coronary spasm can induce sinus bradycardia with dizziness and syncope. In the present case, we reached a diagnosis of paroxysmal atrial fibrillation and sinus bradycardia due to coronary artery spasm using the methyl-ergonovine provocation test during angiography. While the treatment of coronary spasm can resolve paroxysmal atrial fibrillation, sinus bradycardia, and variant angina, the mechanism remains unclear, although it may be associated with sinus node ischemia. Similar symptoms, particularly chest discomfort, should be carefully considered in cases of paroxysmal atrial fibrillation.
Keywords: Atrial fibrillation; Bradycardia; Coronary vasospasm; Ischemia
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