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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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
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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| Summary: | 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. |
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| ISSN: | 2474-252X |