ST-segment elevation during recovery from exercise. A new manifestation of Prinzmetal's variant angina.

Abstract:

:Four patients underwent exercise testing because of a history of pain in the chest; all four developed marked elevation of the S-T segment only during recovery after exercise. Three of the four patients showed ST-segment depression during exercise, but ST-segment elevation was absent until two or more minutes after cessation of exercise. ST-segment elevation after exercise was accompanied by hypotension in three patients and by ventricular arrhythmias in one. Subsequent coronary angiographic studies revealed normal or minimally diseased coronary arteries in two patients and significant coronary lesions in the other two. Review of the literature shows that contrary to the prevailing belief, over half of the patients with Prinzmetal's variant angina have electrocardiographic changes diagnostic of ischemia during exercise testing. Over half of the patients with abnormal findings on tests during exercise display ST-segment elevation as a manifestation of ischemia; however, delayed ST-segment elevation of the type seen in these four patients is distinctly uncommon, having previously been described in only three individual case reports. The pathophysiology of this response is uncertain but may relate to rapid alterations in the autonomic balance during recovery after exercise.

journal_name

Chest

journal_title

Chest

authors

Weiner DA,Schick EC Jr,Hood WB Jr,Ryan TJ

doi

10.1378/chest.74.2.133

subject

Has Abstract

pub_date

1978-08-01 00:00:00

pages

133-8

issue

2

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)39502-2

journal_volume

74

pub_type

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