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A patient with non-ST-segment elevation acute coronary syndrome : Is it possible to predict the culprit coronary artery?

Lindow, Thomas; Pahlm, Olle LU and Nikus, Kjell (2016) In Journal of Electrocardiology
Abstract

In acute coronary syndromes without ST-segment elevation (NSTE-ACS), identification of the culprit artery is, most often, not possible. In this case report, we elaborate on the likelihood of different culprit arteries in a patient with NSTE-ACS. While her symptoms were progressing, typical ECG findings of ischemia in the left coronary territories were diminishing. Instead, dynamic T-wave changes in the inferior leads were present and were most likely postischemic and "reischemic." Although the culprit artery could not be identified with certainty by means of these subtle changes, they correlated well with the findings on angiography and the ECG recorded afterward. This case report demonstrates the importance of analyzing ECG and its... (More)

In acute coronary syndromes without ST-segment elevation (NSTE-ACS), identification of the culprit artery is, most often, not possible. In this case report, we elaborate on the likelihood of different culprit arteries in a patient with NSTE-ACS. While her symptoms were progressing, typical ECG findings of ischemia in the left coronary territories were diminishing. Instead, dynamic T-wave changes in the inferior leads were present and were most likely postischemic and "reischemic." Although the culprit artery could not be identified with certainty by means of these subtle changes, they correlated well with the findings on angiography and the ECG recorded afterward. This case report demonstrates the importance of analyzing ECG and its temporal changes in conjunction with evolving symptoms.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
ECG, Ischemia, ST-segment elevation
in
Journal of Electrocardiology
publisher
Elsevier
external identifiers
  • Scopus:84975478389
ISSN
0022-0736
DOI
10.1016/j.jelectrocard.2016.05.001
language
English
LU publication?
yes
id
99b1c472-4bcb-4669-bfa7-d5ce0f7e1b71
date added to LUP
2016-07-21 12:15:14
date last changed
2016-09-20 03:07:08
@misc{99b1c472-4bcb-4669-bfa7-d5ce0f7e1b71,
  abstract     = {<p>In acute coronary syndromes without ST-segment elevation (NSTE-ACS), identification of the culprit artery is, most often, not possible. In this case report, we elaborate on the likelihood of different culprit arteries in a patient with NSTE-ACS. While her symptoms were progressing, typical ECG findings of ischemia in the left coronary territories were diminishing. Instead, dynamic T-wave changes in the inferior leads were present and were most likely postischemic and "reischemic." Although the culprit artery could not be identified with certainty by means of these subtle changes, they correlated well with the findings on angiography and the ECG recorded afterward. This case report demonstrates the importance of analyzing ECG and its temporal changes in conjunction with evolving symptoms.</p>},
  author       = {Lindow, Thomas and Pahlm, Olle and Nikus, Kjell},
  issn         = {0022-0736},
  keyword      = {ECG,Ischemia,ST-segment elevation},
  language     = {eng},
  publisher    = {ARRAY(0xc29b0a0)},
  series       = {Journal of Electrocardiology},
  title        = {A patient with non-ST-segment elevation acute coronary syndrome : Is it possible to predict the culprit coronary artery?},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2016.05.001},
  year         = {2016},
}