{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:32:19Z","timestamp":1772253139613,"version":"3.50.1"},"reference-count":12,"publisher":"Sociedade Brasileira de Cardiologia","issue":"6","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo A art\u00e9ria do cone (AC) irriga a via de sa\u00edda do ventr\u00edculo direito (VSVD). A eleva\u00e7\u00e3o do segmento ST nas deriva\u00e7\u00f5es V1-3, que pode assemelhar-se aos padr\u00f5es de eletrocardiograma (ECG) de Brugada, foi relatada devido \u00e0 oclus\u00e3o da AC. Um paciente do sexo masculino, 68 anos de idade, foi internado no hospital com diagn\u00f3stico de infarto do mioc\u00e1rdio sem supradesnivelamento do segmento ST. Uma angiografia coron\u00e1ria revelou uma dissec\u00e7\u00e3o na AC, provavelmente causada pelo cateter. Devido ao pequeno calibre da AC, a terapia medicamentosa foi escolhida como curso de a\u00e7\u00e3o. No entanto, ap\u00f3s o procedimento, um ECG mostrou altera\u00e7\u00f5es consistentes com caracter\u00edsticas dos padr\u00f5es de Brugada tipo 1 e tipo 2, com eleva\u00e7\u00f5es do segmento ST nas deriva\u00e7\u00f5es V1-4. A imagem coronariana subsequente revelou que a AC havia progredido para oclus\u00e3o total. Apesar das diversas tentativas de obter a reentrada no l\u00famen verdadeiro, n\u00e3o houve \u00eaxito. Com base na rela\u00e7\u00e3o risco-benef\u00edcio, foi tomada a decis\u00e3o de continuar com a terapia medicamentosa. Este \u00e9 o primeiro caso relatado de oclus\u00e3o da AC induzida por dissec\u00e7\u00e3o por cateter, que se manifesta como eleva\u00e7\u00e3o \u00e2ntero-septal do segmento ST. O paciente n\u00e3o relatou sintomas anginosos ou eventos arr\u00edtmicos, o que contrasta com o conhecimento convencional. Nem todas as obstru\u00e7\u00f5es da AC ou infartos da VSVD causam padr\u00f5es semelhantes aos de Brugada. Quando isso ocorre, as eleva\u00e7\u00f5es de ST tendem a ser menores do que as da verdadeira s\u00edndrome de Brugada.<\/jats:p>","DOI":"10.36660\/abc.20230749","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T16:21:33Z","timestamp":1721924493000},"source":"Crossref","is-referenced-by-count":0,"title":["Eleva\u00e7\u00e3o Enganosa do Segmento ST \u00c2ntero-Septal e Padr\u00e3o de Brugada Causado por Oclus\u00e3o Isolada da Art\u00e9ria do Cone"],"prefix":"10.36660","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4194-0579","authenticated-orcid":false,"given":"Hakan G\u00f6kalp","family":"Uzun","sequence":"first","affiliation":[{"name":"Izmir Tepecik Training and Research Hospital,  Turquia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0130rfan","family":"\u00d6zgen","sequence":"additional","affiliation":[{"name":"Izmir Tepecik Training and Research Hospital,  Turquia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2024]]},"reference":[{"issue":"3","key":"ref1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.121.010630","article-title":"Electrophysiology and Arrhythmogenesis in the Human Right Ventricular Outflow Tract","volume":"15","author":"Aras K","year":"2022","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"4","key":"ref2","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1161\/01.CIR.63.4.833","article-title":"Frequency and Clinical Significance of Failure to Visualize the Conus Artery During Coronary Arteriography","volume":"63","author":"Levin DC","year":"1981","journal-title":"Circulation"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1016\/j.hrthm.2009.02.041","article-title":"Type 1 ST-segment Elevation in the Right Precordial Leads Associated with Acetylcholine-induced Localized Spasm of the Conus Branch of the Right Coronary Artery","volume":"6","author":"Ihara K","year":"2009","journal-title":"Heart Rhythm"},{"key":"ref4","first-page":"94","article-title":"Electrical Storm After Conus Branch Occlusion","volume":"2","author":"Riede FN","year":"2018","journal-title":"IHJ Cardiovasc Case Reports"},{"issue":"3","key":"ref5","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.ijcard.2009.03.062","article-title":"Ischemia-induced Brugada-type ST-Segment Alternans and Brugada Syndrome","volume":"144","author":"Omichi C","year":"2010","journal-title":"Int J Cardiol"},{"issue":"1","key":"ref6","first-page":"58","article-title":"Ventricular Fibrillation Followed by the Augmentation of Brugada-like Electrocardiographic Changes Caused by Ischemia of the Conus Branch in a Patient with Coronary Artery Disease","volume":"2","author":"Nagamoto Y","year":"2018","journal-title":"IHJ Cardiovasc Case Reports"},{"issue":"3","key":"ref7","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1253\/circj.CJ-16-1112","article-title":"Life-Threatening Ventricular Arrhythmia and Brugada-Type ST-Segment Elevation Associated With Acute Ischemia of the Right Ventricular Outflow Tract","volume":"81","author":"Nakamura R","year":"2017","journal-title":"Circ J"},{"issue":"5","key":"ref8","first-page":"497","article-title":"Precordial ST-Segment Elevation Caused by Proximal Occlusion of a Non-Dominant Right Coronary Artery","volume":"30","author":"Lin YN","year":"2014","journal-title":"Acta Cardiol Sin"},{"issue":"6","key":"ref9","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1111\/pace.13678","article-title":"Link Between Brugada Phenocopy and Myocardial Ischemia: Results from the International Registry on Brugada Phenocopy","volume":"42","author":"Xu G","year":"2019","journal-title":"Pacing Clin Electrophysiol"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1016\/S0735-1097(02)02494-4","article-title":"ST-segment Elevation and Ventricular Fibrillation Without Coronary Spasm by Intracoronary Injection of Acetylcholine and\/or Ergonovine Maleate in Patients with Brugada Syndrome","volume":"40","author":"Noda T","year":"2002","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"ref11","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.cpcardiol.2015.06.002","article-title":"Brugada Syndrome: Clinical, Genetic, Molecular, Cellular, and Ionic Aspects","volume":"41","author":"Antzelevitch C","year":"2016","journal-title":"Curr Probl Cardiol"},{"issue":"12","key":"ref12","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1016\/j.cjca.2014.09.023","article-title":"Brugada Phenocopies: Consideration of Morphologic Criteria and Early Findings From an International Registry","volume":"30","author":"Anselm DD","year":"2014","journal-title":"Can J Cardiol"}],"container-title":["Arquivos Brasileiros de Cardiologia"],"original-title":["Deceptive Anteroseptal ST-segment Elevation and Brugada Pattern Caused by Isolated Conus Artery 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