PMID: 7015817Jun 1, 1981Paper

S-T segment elevation and coronary spasm in response to exercise

The American Journal of Cardiology
B R ChaitmanJ S Hanson

Abstract

The prevalence rate of exercise- S-T segment elevation of 0.1 mV or greater in symptomatic patients is 3.0 to 6.5 percent in most studies. S-T segment elevation is associated with a more severe degree of myocardial ischemia than depression and frequently implies a high grade coronary stenosis in the vessel that supplies the site of ischemia. Leads V4 to V6 and bipolar lead CM5 have been found to be relatively insensitive in detecting exercise-induced S-T segment elevation. The pathogenesis of S-T segment elevation is different in three clinical patient subsets reviewed. In patients afer infarction, the largest of the three subgroups, exercise-induced S-T segment elevation usually appears in leads with Q waves, is more common after anterior myocardial infarction and implies underlying akinetic of dyskinetic wall motion. Of patients with variant angina, 10 to 30 percent have during exercise S-T segment elevation that is most likely provoked by coronary arterial spasm. The natural history of variant angina is cyclic, and clinical observations and laboratory findings are dependent on particular phases in the disease process and treatment. Finally, 0.2 to 1.7 percent of symptomatic patients without infarction or variant angina have ...Continue Reading

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Citations

May 1, 1992·Clinical Cardiology·D G CaralisR Castello
Oct 27, 2015·The American Journal of Cardiology·Mazen M Kawji, D Luke Glancy
Nov 1, 1984·The American Journal of Medicine·E J Topol, N J Fortuin
Jun 1, 1991·American Heart Journal·M Perez de Juan Romero, L Fernandez Dominguez
Mar 1, 1987·Clinical Cardiology·T Fuller, A Movahed
Jan 18, 2018·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Ayman A FaragFadi G Hage
Sep 1, 1984·Clinical Cardiology·T Bashour
Mar 1, 1987·Journal of Cardiac Surgery·C R Conti

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