A 54-year-old male was admitted to the hospital due to a one-hour episode of chest pain.
ECG showed Q waves along with ST-segments in inferior leads and D-ST in leads I, aVL and V4-V5.
A marked J wave was also observed in right precordial leads, followed by a convex and descending D-ST that ended in a negative T wave.
With the diagnosis of inferior AMI, he received fibrinolytic treatment with tenecteplase.
An hour after the ECG, recorded with mild precordial pain, revealed absence of inferior STE, a negative T wave in aVL and an elevation of the J point > 0.2 mV with descending E-ST and negative T wave in dementia.
The ECG hours later showed a prominent J-wave with convex TSS and Five-mount in leads V1 and V2, respectively.
There was also a J-point elevation associated with ST-segment elevation and positive T-wave in leads V3-V4.
Three days after admission ECG showed a lower qR pattern along with a negative T wave in leads III and aVF, a J wave manifest in V1-V2, a concave T-ST leads in left V2-wave.
While he was admitted he had no ventricular arrhythmias.
The maximum value of creatine kinase and troponin I were 1,398 U/l and 23.2 ng/ml, respectively.
Coronary arteriography revealed proximal (95%) stenosis of the right coronary artery and a stent was placed.
After being discharged, 6 months later he underwent a challenge test with flecainide (2 mg/kg intravenously in 10 minutes) which was negative to make a diagnosis of BS.
