Transient silent ischemia after percutaneous transluminal coronary angioplasty manifested with a bizarre electrocardiogram

hERG K+Channels: Structure, Function, and Clinical Significance

“…Triangulation is proarrhythmic because it both increases the propensity for arrhythmogenic triggers such as EADs (due to increased time in calcium and sodium window currents) and for substrates of arrhythmia like reentry and transmural dispersion of repolarization (TDR) (266,267,567). Clinically, triangulation manifests as wider, flatter, and often notched T-waves that precede TdP, although caution must be taken in using T-wave morpholhERG K ϩ CHANNELS ogy as an indicator of TdP as there may be other causes for this phenotype (451,467).…”

Intimidating Electrocardiographic Changes in an Asymptomatic Patient: Arterial Pulse Tapping Artifact

“…This phenomenon occurs due to tapping of arterial pulse on the ECG electrodes, which is known as arterial pulse tapping artifact. Such bizarre ECG changes were first reported by Ozhan et al 1 post-percutaneous coronary intervention patient, which he initially attributed to silent ischemia. However, it was Aslanger and Bjerregaard 2 who described that the mechanism of those ECG changes was indeed due to arterial pulse.…”

Bizarre electrocardiographic changes during occlusion of a congenital coronary arteriovenous fistula

“…1,2,8 Some percutaneous coronary interventions are associated with angina and asymptomatic ischaemic episodes, called silent myocardial ischaemic episodes. [3][4][5]9 Silent myocardial ischaemic patients have generally reduced sensitivity to pain felt during ischaemic episodes. Healthy asymptomatic patients and patients with coronary artery disease are all at higher risk for subsequent cardiovascular morbidity if there is evidence of silent ischaemia.…”

“…Healthy asymptomatic patients and patients with coronary artery disease are all at higher risk for subsequent cardiovascular morbidity if there is evidence of silent ischaemia. [3][4][5]9 This report describes a patient whose coronary arteriovenous fistula was treated successfully with percutaneous intervention. Although no complication occurred during the procedure, electrocardiography recorded episodes of ischaemia at the time of closure of the fistula artery.…”

“…2 These patients are frequently asymptomatic; however, they can present with symptoms of dyspnoea, chest pain, and arrhythmias necessitating therapy. [3][4][5] As an alternative to surgery, percutaneous closure of the coronary arteriovenous fistula may be proposed in symptomatic patients. 6,7 We describe a case of a successful percutaneous closure of a coronary arteriovenous fistula in a patient who experienced transient myocardial ischaemia during the procedure along with changes in electrocardiography.…”