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

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Abstract

Rationale:

ST-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 concerns:

In 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.

Diagnoses:

Vasospastic angina (VSA) was diagnosed based on electrocardiography and coronary angiography.

Interventions:

Calcium antagonists were prescribed for both patients.

Outcomes:

No recurrent VSA was noted during outpatient follow-up.

Lessons:

VSA 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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