Left anterior fascicular block secondary to coronary artery spasm.

Spasm of the left anterior descending coronary artery occurred during cardiac calheterization in a 52 year old patient with a history of syncope and a chest pain syndrome. The main feature of coronary spasm was left axis deviation consistent with left anterior fascicular block. Electrical axis reverted to normality after sublingual nitroglycerin. Coronary angiography was repeated and showed a normal coronary artery tree. This report documents axis shift as a feature of coronary spasm and supports the concept ofischemic left anterior hemiblock. [ABSTRACT FROM PUBLISHER]