Vasospastic angina accompanied by Brugada-type electrocardiographic abnormalities

Brugada Syndrome and Vasospastic Angina. We present two patients with vasos pastic angina and Brugada-type ECG abnormalities. The first patient complai ned of chest pain, and transient ST segment elevation was confirmed on EGG. Coronary angiogram showed no organic stenosis. The second patient had sync opal episodes following anginal chest pain, and the same symptoms were repr oduced by intracoronary acetylcholine injection that Induced vasospasm. In both patients, ECG at rest showed ST segment elevation in leads V-1 and V-2 and a right bundle branch block pattern that were accentuated by a Class I antiarrhythmic drug. Ventricular fibrillation also was induced by programm ed electrical stimulation. Susceptibility to ventricular fibrillation can b e modulated by the interaction of coronary vasospasm with Brugada syndrome or vice versa; therefore, it is important to study the clinical implication s of the coexistence of the two diseases in such patients.