Upsloping ST depression: Is it acute ischemia?
Mahboob AlamKjell NikusMiguel FiolAntonio Bayes de LunaYochai BirnbaumPublished in: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc (2018)
We describe a patient with acute coronary syndrome, presenting with upsloping ST depression in leads I, II, V3-V6 and ST elevation in lead aVR. Coronary angiography revealed spontaneous dissection in a big, dominant left circumflex artery. No other lesions identified. During stenting of the dissection site, the distal left circumflex, supplying a large posterior descending artery was occluded, resulting in ST elevation myocardial infarction with ST elevation in lead III and aVF, but not II. This pattern is considered to represent right coronary artery infarction, rather than left circumflex infarction.
Keyphrases
- st elevation myocardial infarction
- acute coronary syndrome
- percutaneous coronary intervention
- coronary artery
- depressive symptoms
- antiplatelet therapy
- case report
- liver failure
- pulmonary artery
- minimally invasive
- big data
- intensive care unit
- machine learning
- mechanical ventilation
- pulmonary hypertension
- artificial intelligence