Work

ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization?

Year: 2024

Type: article

Abstract: CASE PRESENTATION: A 33-year-old female with a history of antiphospholipid syndrome presented with exertional chest pain and ST-elevation in aVR with diffuse ST-segment depression. An emergent catheterization was performed, which showed an isolated 99% stenosis in the left main coronary artery. The remaining coronary arteries were without any stenosis. Successful stent placement was performed, and the patient was discharged without complications. DISCUSSION: Previous guidelines have suggested that ST-segment elevation with diffuse ST-segment depression should be treated as a ST-elevation myocardial infarction equivalent involving either the left-main or proximal left anterior descending coronary artery. However, recent data suggests that most of these cases may not involve that region. Regardless, this electrocardiogram finding should still be a concern for acute coronary syndrome, with the need for urgent catheterization.

Source: Clinical Practice and Cases in Emergency Medicine

DOI: 10.5811/cpcem.35284

Authors: Bruce M Lo, Megyn K Christensen, Katherine Schaffer, Theodore J Tzavaras

Institutions: Sentara Norfolk General Hospital, Eastern Virginia Medical School, Old Dominion University

Language: English

Topic: Acute Myocardial Infarction Research

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $500