ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization?
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...
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eScholarship Publishing, University of California
2024-12-01
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Series: | Clinical Practice and Cases in Emergency Medicine |
Online Access: | https://escholarship.org/uc/item/4601x21r |
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author | Bruce M. Lo Megyn K. Christensen Katherine E. Schaffer Theodore J. Tzavaras |
author_facet | Bruce M. Lo Megyn K. Christensen Katherine E. Schaffer Theodore J. Tzavaras |
author_sort | Bruce M. Lo |
collection | DOAJ |
description | 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. |
format | Article |
id | doaj-art-8106354d0bb743d6986aa8f21c4e575c |
institution | Kabale University |
issn | 2474-252X |
language | English |
publishDate | 2024-12-01 |
publisher | eScholarship Publishing, University of California |
record_format | Article |
series | Clinical Practice and Cases in Emergency Medicine |
spelling | doaj-art-8106354d0bb743d6986aa8f21c4e575c2025-02-04T17:35:18ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2024-12-019110911010.5811/cpcem.35284cpcem-9-109ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization?Bruce M. Lo0Megyn K. Christensen1Katherine E. Schaffer2Theodore J. Tzavaras3Sentara Norfolk General Hospital/Eastern Virginia Medical School at Old Dominion University, Norfolk, VirginiaEastern Virginia Medical School at Old Dominion University, Norfolk, VirginiaEastern Virginia Medical School at Old Dominion University, Norfolk, VirginiaSentara Norfolk General Hospital/Eastern Virginia Medical School at Old Dominion University, Norfolk, VirginiaCase 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.https://escholarship.org/uc/item/4601x21r |
spellingShingle | Bruce M. Lo Megyn K. Christensen Katherine E. Schaffer Theodore J. Tzavaras ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization? Clinical Practice and Cases in Emergency Medicine |
title | ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization? |
title_full | ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization? |
title_fullStr | ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization? |
title_full_unstemmed | ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization? |
title_short | ST-elevation in aVR with Diffuse ST-segment Depression: Need for Urgent Catheterization? |
title_sort | st elevation in avr with diffuse st segment depression need for urgent catheterization |
url | https://escholarship.org/uc/item/4601x21r |
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