• Medicine · Mar 2017

    Case Reports

    Fluctuations in the amplitude of ST-segment elevation in vasospastic angina: Two case reports.

    • Ming-Jui Hung.
    • Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Chang Gung University College of Medicine, Keelung City, Taiwan.
    • Medicine (Baltimore). 2017 Mar 1; 96 (11): e6334.

    RationaleST-segment elevation localizes an ischemic lesion to the coronary artery supplying the area of the myocardium reflected by the electrocardiographic leads. Dynamic ST-segment elevation can be due to severe transmural ischemia secondary to a thrombus, vasospasm, or a tightly fixed coronary artery lesion or a combination of these situations.Patient ConcernsIn this study, we report on two patients with angina who had fluctuations in ST-segment amplitude on serial electrocardiograms. The amplitude of ST-segment elevation varied between 1-20 mm.DiagnosesVasospastic angina (VSA) was diagnosed based on electrocardiography and coronary angiography.InterventionsCalcium antagonists were prescribed for both patients.OutcomesNo recurrent VSA was noted during outpatient follow-up.LessonsVSA can be associated with fluctuations in the amplitude of ST-segment elevation, indicating dynamic coronary vasospasm in different locations and extensions in patients with VSA.

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