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[Long-term frequency-modulated ECG recordings after PTCA in a patient with unstable angina pectoris. A case report]
Insights
Frequency-modulated Holter monitoring effectively identified ST segment depressions in unstable angina patients. This method confirmed the ischemic cause before, during, and after percutaneous transluminal coronary angioplasty (PTCA).
Area of Science:
- Cardiology
- Diagnostic Monitoring
Background:
- Unstable angina (UA) is a critical condition often caused by severe coronary artery stenosis.
- Assessing myocardial ischemia requires accurate and sensitive diagnostic tools.
Observation:
- A patient with severe left anterior descending coronary artery stenosis experienced ST segment depressions during Holter monitoring.
- These episodes correlated with both symptomatic angina and asymptomatic ischemia.
- ST segment changes were also observed during percutaneous transluminal coronary angioplasty (PTCA) balloon inflations.
Findings:
- Frequency-modulated Holter monitoring demonstrated ST segment depressions (≥0.1 mV) in 6 episodes.
- PTCA successfully resolved the coronary stenosis.
- Post-PTCA Holter monitoring showed no significant ST segment changes, indicating resolution of ischemia.
Implications:
- Frequency-modulated Holter monitoring is a valuable tool for diagnosing and monitoring myocardial ischemia in unstable angina.
- This technique can confirm the ischemic origin of ST segment changes, aiding in treatment decisions.
- Successful PTCA effectively relieved ischemia, as evidenced by the absence of ST segment changes post-procedure.
Abstract:
A patient presenting with unstable angina due to severe stenosis of the left anterior descending coronary artery encountered 6 episodes with ST segment depressions greater than or equal to 0.1 mV during frequency-modulated Holter monitoring. Four episodes were associated with anginal pain, 2 were asymptomatic. Percutaneous transluminal coronary angioplasty (PTCA) was performed. During balloon inflations horizontal ST segment depressions occurred. After successful PTCA, the patient remained asymptomatic and no significant ST segment changes were detected by Holter monitoring. Thus, by frequency-modulated Holter monitoring before, during, and after PTCA, the ischaemic cause of episodes with ST segment depressions greater than or equal to 0.1 mV could be demonstrated.