Document Detail

Clinical characteristics of patients with exercise-induced ST-segment elevation without prior myocardial infarction.
MedLine Citation:
PMID:  16501289     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Exercise-induced ST-segment elevation is a relatively uncommon problem and occurs more frequently in patients who have had a myocardial infarction. Data is limited on the characteristics of Taiwanese patients without prior myocardial infarction who develop exercise-induced ST-segment elevation. METHODS AND RESULTS: Exercise-induced ST-segment elevation developed in 9 of 6,147 consecutive patients without myocardial infarction who underwent treadmill exercise testing at out institution over a 4-year period. The clinical and angiographic characteristics of these patients were studied. Angiographically normal coronary arteries with coronary vasospasm were found in 5 patients, hemodynamically significant coronary stenosis was found in 3 patients, and coexisting spasm in angiographically normal coronary arteries combined with hemodynamically significant coronary stenosis in the different vessel was found in 1 patient. During a median follow-up of 71 months, 2 patients with coronary vasospasm developed recurrent angina after self-discontinuation of calcium antagonists and 2 patients (1 with coronary vasospasm and 1 with hemodynamically significant coronary stenosis) died of cardiac causes before arrival at the emergency department. CONCLUSION: Coronary vasospasm was a more common underlying pathology of exercise-induced ST-segment elevation in this Taiwanese cohort. Coronary angiography +/- intracoronary ergonovine provocation testing is necessary in these patients to identify the underlying pathology and appropriate treatment.
Ming-Jui Hung; Ming-Yow Hung; Chi-Wen Cheng; Ning-I Yang; Wen-Jin Cherng
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  70     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-27     Completed Date:  2006-04-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  254-61     Citation Subset:  IM    
Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Taiwan.
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MeSH Terms
Acute Disease
Cohort Studies
Coronary Angiography*
Coronary Circulation
Coronary Stenosis / diagnosis,  physiopathology
Coronary Vasospasm / diagnosis,  physiopathology*
Coronary Vessels / physiopathology
Exercise Test
Follow-Up Studies
Heart / drug effects,  physiopathology*
Heart Function Tests*
Methylergonovine / diagnostic use
Middle Aged
Myocardial Infarction / physiopathology*
Reg. No./Substance:

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