ST-segment elevation in non-atherosclerotic coronaries: a brief overview
Subhash Chandra1, Vikas Singh, Mahendra Nehra
1Department of Emergency Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA. chandra.subhash@mayo.edu
Internal and Emergency Medicine
|December 15, 2010
Summary
ST elevation on electrocardiograms can occur without coronary artery disease. This review covers conditions causing ST elevation despite normal coronary angiograms, including anomalous coronaries and myocardial injury.
Area of Science:
- Cardiology
- Emergency Medicine
- Internal Medicine
Background:
- ST elevation on electrocardiograms (ECG) often indicates acute myocardial infarction due to coronary artery occlusion.
- However, ST elevation can present without significant atherosclerotic lesions found during coronary angiography.
Purpose of the Study:
- To inform emergency medicine physicians and internists about conditions causing ST elevation with normal coronary angiograms.
- To review diverse causes of myocardial injury presenting with ST elevation and no obstructive coronary artery disease.
Main Methods:
- This is a clinical review article.
- It synthesizes information on conditions associated with ST elevation and normal coronary angiography findings.
Main Results:
- ST elevation can occur in the absence of obstructive coronary atherosclerosis.
- Conditions range from coronary artery anomalies to anatomically normal coronaries with myocardial injury.
Conclusions:
- Physicians should consider non-atherosclerotic causes of ST elevation.
- Differential diagnosis is crucial for patients with ST elevation and normal coronary angiograms.
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