Transient electrocardiographic recording of acute myocardial ischemia with ST-segment elevation of the diaphragmal location accompanied by a total atrioventricular block as an initial manifestation of Prinzmetal’s angina — A case report

Open Medicine ◽  
2007 ◽  
Vol 2 (1) ◽  
pp. 108-115
Author(s):  
Krunoslav Fuckar ◽  
Nenad Lakusic ◽  
Hrvoje Stipic
Keyword(s):  
Case Report ◽  
Myocardial Ischemia ◽  
Atrioventricular Block ◽  
Coronary Arteries ◽  
Calcium Antagonists ◽  
Acute Myocardial Ischemia ◽  
Vasospastic Angina ◽  
St Segment Elevation ◽  
St Segment ◽  
Total Atrioventricular Block

AbstractPrinzmetal’s angina, also known as Prinzmetal’s variant or Prinzmetal’s vasospastic angina is characterized by angina attacks caused by spasm of the great epicardial coronary arteries. Coronary artery endothelial dysfunction plays a crucial role in the development of this vasospastic angina. The attacks of vasospastic angina can be prevented with calcium antagonists and nitrates, whereas in refractory variant angina, coronary angioplasty with stenting may help prevent further coronary spasm. In this case report, we present a 52-year-old male patient with a transient electrocardiographic recording of acute myocardial ischemia with ST-segment elevation of the diaphragmal location accompanied by a total atrioventricular block immediately after exercise testing and as a first manifestation of Prinzmetal’s angina. After regression of the symptoms and electrocardiographic changes, significant pathomorphologic changes of coronary arteries were excluded by coronary angiography. Following discharge, the patient was treated with calcium antagonists and did not show symptoms during a 4-year follow-up period.

Comparison of high-frequency QRS components and ST-segment elevation to detect and quantify acute myocardial ischemia

2010 ◽  
Vol 43 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Michael Ringborn ◽  
Jonas Pettersson ◽  
Eva Persson ◽  
Stafford G. Warren ◽  
Pyotr Platonov ◽  
...  
Keyword(s):  
Myocardial Ischemia ◽  
High Frequency ◽  
Acute Myocardial Ischemia ◽  
St Segment Elevation ◽  
St Segment

scholarly journals Vasospasm or Atherosclerotic Lesion of Coronary Arteries: Case Management

2019 ◽  
pp. 87-90
Author(s):  
V. K. Tashchuk ◽  
I. O. Makoviichuk ◽  
M. V. Al Salama ◽  
O. V. Malinevska-Biliichuk ◽  
S. S. Biletskiy ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Ischemia ◽  
Coronary Arteries ◽  
Atherosclerotic Lesion ◽  
Diagnostic Procedures ◽  
Silent Myocardial Ischemia ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

  Background. Coronary artery vasospasm (CVS) is an important mechanism of myocardial ischemia which can produce any of the manifestations of coronary artery disease from silent myocardial ischemia to acute coronary syndrome including myocardial infarction or sudden cardiac death. One of the main markers of CVS is retrosternal pain not associated with increased myocardial oxygen requirement such as that due to exercise or emotional excitement with frequent attacks in the morning and temporary ST segment elevation. Some patients have variant angina caused by the spasm of coronary arteries (СА) coupled with stable angina provoked by emotional and physical stress. Such patients have decreased exercise tolerance. Aim. To determine the feasibility and subsequence of the appointment of diagnostic procedures such as electrocardiography (ECG), bicycle ergometry (BEM), provocative tests and coronary angiography and left ventriculography (CAG & LVG) in order to visualize СА, to make the choice of patient’s management and to assign an adequate therapeutic program. Materials and methods. The patient who was admitted with complaints about progression of angina and shortness of breath received the full complex of diagnostic manipulations. The purpose was to verify the diagnosis and to prescribe an adequate treatment. Results. This clinical case shows the subsequence of the appointment of diagnostic procedures to the patient who has normal ECG, ST segment elevation on BEM and progression of angina attacks, that is, the necessity of the widespread introduction of coronary angiography. Conclusion. This article shows the necessity of appointment of CAG & LVG. CAG & LVG revealed atherosclerotic lesion of CA which caused chest paint, ST segment elevation, and this result confounded the presence of CVS as a cause of complaints in this patient. The patient underwent stenting of the affected CA which helped to eliminate the cause of pain and is compatible with adequate therapeutic tactics for patients with CA stenosis.

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