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Electrical alternans of the ST segment in non-Prinzmetal's angina
Insights
Elevated ST-segment alternans (STEA) can occur in myocardial ischemia due to severe coronary artery disease, not just Prinzmetal's angina. This finding suggests coronary obstructions are key causes of STEA during exercise.
Area of Science:
- Cardiology
- Clinical Medicine
- Diagnostic Electrocardiography
Background:
- ST-segment elevation alternans (STEA) is typically associated with Prinzmetal's angina.
- Severe atherosclerotic coronary artery disease can cause myocardial ischemia.
Observation:
- ST-segment elevation alternans (STEA) was observed in a patient with non-Prinzmetal's angina and severe coronary artery disease.
- STEA was triggered by graded exercise testing in this patient.
Findings:
- The patient's STEA resolved after aortocoronary bypass surgery.
- This suggests that coronary artery obstructions were the cause of the observed STEA.
Implications:
- ST-segment elevation alternans (STEA) may be a sign of myocardial ischemia in conditions beyond Prinzmetal's angina.
- This broadens the diagnostic considerations for STEA in patients with coronary artery disease.
Abstract:
Elevated electrical alternans of the elevated ST segment (STEA) was documented in a patient with non-Prinzmetal's or classical angina and severe atherosclerotic coronary artery disease. STEA was precipitated during graded exercise testing. The disappearance of this phenomenon after aortocoronary bypass surgery suggests that the coronary obstructions were the etiologic factors. These findings emphasize that the STEA may occur in myocardial ischemia caused by conditions other than Prinzmetal's angina.