Exercise-induced ST segment elevation in a patient with effort angina pectoris and normal coronary arteries |
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Authors: | J W Noneman K A Popio D S Sheps |
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Affiliation: | From the Department of Medicine, The University of North Carolina School of Medicine, Chapel Hill, North Carolina. |
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Abstract: | A 32 year old woman who complained of exercise-induced chest pain was found to have widespread elevation of the ST segment of the electrocardiogram during exercise testing. Coronary angiography demonstrated no obstructive lesions and no evidence of coronary artery spasm despite ergonovine administration, bicycle ergometry and rapid atrial pacing. Exercise thallium-201 scintigraphy demonstrated no perfusion defects despite ST segment elevation. Radionuclide blood pool imaging revealed a slight decrease in ejection fraction with exercise. The available evidence raises the possibility of small vessel coronary artery disease, either structural or vasotonic, as a cause of this patient's symptoms. |
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Keywords: | Address for reprints: Jack W. Noneman MD Division of Cardiology The University of North Carolina School of Medicine 338 Clinical Sciences Building 229H Chapel Hill North Carolina 27514. |
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