Exercise-induced ST-segment elevation possibly caused by coronary artery spasm : a case presentation and review
Date
1985-09
Authors
Przybojewski, J. Z.
Thorpe, L.
Journal Title
Journal ISSN
Volume Title
Publisher
Health and Medical Publishing Group (HMPG)
Abstract
A 36-year-old man with classic angina pectoris had
marked ST-segment elevation (STE) in the inferior
leads on stress-testing in the absence of chest pain.
There was no evidence of previous myocardial
infarction (MI). Selective coronary arteriography delineated
severe obstructions in the' right coronary
artery (RCA) with additional left circumflex coronary
artery (LCx) obstruction. Left ventricular cine-angiography
established that there was normal contractility
and confirmed the absence of past MI. Coronary
artery bypass graft surgery to the RCA and LCx was
unfortunately complicated by an acute transmural
inferoposterolateral MI. Treadmill stress testing 6
weeks after surgery failed to demonstrate the preoperative
ST-segment change. The patient may have
developed exercise-induced coronary artery spasm
superimposed on the severe proximal RCA stenosis;
this in turn may have caused the -inferior STE. Exercise-
induced STE is reviewed.
Description
The original publication is available at http://archive.samj.org.za/
Keywords
Coronary vasospasm
Citation
Przybojewski, J. Z. & Thorpe, L. 1985. Exercise-induced ST-segment elevation possibly caused by coronary artery spasm. A case presentation and review. South African Medical Journal, 68(6):419-424.