Post-exercise ST segment elevation preceding myocardial infarction in a patient with nearly normal coronary arteries.

2002 ◽  
Vol 82 (1) ◽  
pp. 69-70 ◽  
Author(s):  
Eleftheria P Tsagalou ◽  
John N Nanas
Keyword(s):  
Myocardial Infarction ◽  
Coronary Arteries ◽  
Post Exercise ◽  
Normal Coronary Arteries ◽  
St Segment Elevation ◽  
St Segment

scholarly journals ST elevation in recovery post exercise with normal coronary arteries

2019 ◽  
Vol 12 (7) ◽  
pp. e229766
Author(s):  
Reza Aghamohammadzadeh ◽  
Suhaib Magdi El-Omar ◽  
Derek Rowlands ◽  
Magdi El-Omar
Keyword(s):  
Blood Pressure ◽  
Coronary Arteries ◽  
Myocardial Ischaemia ◽  
Coronary Spasm ◽  
Post Exercise ◽  
Normal Coronary Arteries ◽  
St Segment Elevation ◽  
St Segment ◽  
St Elevation ◽  
Marked Drop

We present the case of a 45-year-old healthy man who successfully completed three stages of the Bruce protocol but developed inferolateral ST segment elevation in the recovery phase. The ECG change was associated with a marked drop in blood pressure. He underwent emergency coronary angiography which revealed normal coronary arteries. It is likely that post-exercise hypotension triggered coronary spasm which caused the ST segment elevation. Alternatively, coronary spasm may have been the primary event, inducing sufficient myocardial ischaemia to cause a marked drop in blood pressure. Exercise tolerance testing is often a reliable test to rule out reversible myocardial ischaemia. While the physician is focused on ischaemic changes or rhythm abnormalities developing during the exercise phase, the recovery period is just as important and requires as much vigilance. Coronary vasospasm can result in significant ST changes and haemodynamic compromise at any point during the test, and the ECG traces can be indistinguishable from a classic ST elevation myocardial infarction, as in the present case.

scholarly journals ST-Segment Elevation Myocardial Infarction with Normal Coronary Arteries Angiography

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Morteza Motedayen ◽  
Hamid Khederlou
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Artery Dissection ◽  
Beta Blockade ◽  
Normal Coronary Arteries ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Epicardial Coronary Artery ◽  
St Segment

: Myocardial infarction (MI) is the most frequent cause of ischemic heart death. MI is generally assumed to be due to arterial thrombosis superimposed on an atherosclerotic plaque in an epicardial coronary artery. Total occlusion of an epicardial coronary artery leads to ST elevation, while non-occlusive lesion leads to ST depression. We hereby have reported a case of ST-segment elevation myocardial infarction with normal coronary arteries angiography. A 35-year-old man presented with typical chest pain, nausea, vomiting and cold sweating. ECG obtained at admission and 30 minutes later revealed sinus tachycardia with ST-segment elevations (> 2 mm) in leads V2-V5. Cardiac biomarkers including creatine phosphokinase (CPK), creatine kinase muscle-brain (CK.MB) and troponin high sensitive were elevated. The standard treatment for MI including pain relief, aspirin, thrombolysis if indicated and beta blockade were begun for the patient. STEMI was confirmed and thus, angiography was performed. Coronary angiography revealed normal coronary arteries without any angiographic evidence of stenosis, coronary artery dissection, embolism, plaque rupture or vasospasm.

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