ST SEGMENT DEPRESSION IN ASYMPTOMATIC MALE PATIENT WITH NORMAL CORONARY ARTERIES

Authors

  • O. MITU University of Medicine and Pharmacy”Grigore T. Popa”- Iasi
  • F. MITU University of Medicine and Pharmacy”Grigore T. Popa”- Iasi
  • Maria Magdalena LEON University of Medicine and Pharmacy”Grigore T. Popa”- Iasi
  • M. ROCA University of Medicine and Pharmacy”Grigore T. Popa”- Iasi
  • Mariana GRAUR University of Medicine and Pharmacy”Grigore T. Popa”- Iasi

Abstract

ST segment depression and T waves inversion are electrocardiographic (ECG) repolarization abnormalities often encountered in clinical medical practice that have been proved to predict future cardiovascular events. We present the case of a 62-year-old male patient, asymptomatic, with ST segment depression and inverted T waves discovered incidentally on resting ECG. Echocardiographic and laboratory examinations ruled out multiple causes of ECG abnormalities. Suspecting a silent myocardial ischemia, an ECG exercise stress test was performed; it revealed pseudo normalization of T waves during exercise and early recovery phase. Being inconclusive, a coronary CT was the final election test; it showed normal coronary arteries with no stenosis, the patient being scheduled for regular follow-up. The possible causes of ST segment depression are reviewed since it is important that early cardiovascular signs especially in asymptomatic patients to be prevented and detected.

Author Biographies

  • O. MITU, University of Medicine and Pharmacy”Grigore T. Popa”- Iasi

    Faculty of Medicine
    Department of Medical Specialties (I)

  • F. MITU, University of Medicine and Pharmacy”Grigore T. Popa”- Iasi

    Faculty of Medicine
    Department of Medical Specialties (I)

  • Maria Magdalena LEON, University of Medicine and Pharmacy”Grigore T. Popa”- Iasi

    Faculty of Medicine
    Department of Medical Specialties (I)

  • M. ROCA, University of Medicine and Pharmacy”Grigore T. Popa”- Iasi

    Faculty of Medicine
    Department of Medical Specialties (I)

  • Mariana GRAUR, University of Medicine and Pharmacy”Grigore T. Popa”- Iasi

    Faculty of Medicine
    Department of Medical Specialties (I)

References

1. Hanna EB, Glancy DL. ST-segment depression and T-wave inversion: classification, differential diagnosis, and caveats. Cleve Clin J Med 2011; 78(6): 404-414.
2. Braunwald E. Braunwald's Heart Disease - A Textbook of Cardiovascular Medicine. Elsevier Saunders, 2012.
3. Hsieh BP, Pham MX, Froelicher VF. Prognostic value of electrocardiographic criteria for left ventric-ular hypertrophy. Am Heart J 2005; 150(1): 161-167.
4. Montalescot G, Sechtem U, Achenbach S et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013; 34(38): 2949-3003.
5. Conti CR, Bavry AA, Petersen JW. Silent ischemia: clinical relevance. J Am Coll Cardiol 2012; 59(5): 435-441.
6. Crea F, Camici PG, Bairey Merz CN. Coronary micro vascular dysfunction: an update. Eur Heart J 2014; 35(17): 1101-1111.
7. Ciccone MM, Scicchitano P, Zito A et al. Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency. Cardiovasc Ultrasound 2011; 9: 32-36.
8. Mitu F, Mitu O, Dimitriu C et al. Significance of arterial stiffness and relationship with other nonin-vasive methods for the assessment of subclinical atherosclerosis in patients with metabolic syndrome. Rev Med Chir Soc Med Nat Iasi 2013; 117(1): 59-64.
9. Kansal S, Roitman D, Sheffield LT. Stress testing with ST-segment depression at rest. An angiographic correlation. Circulation 1976; 54(4): 636-639.
10. Miranda CP, Lehmann KG, Froelicher VF. Correlation between resting ST segment depression, exercise testing, coronary angiography, and long-term prognosis. Am Heart J 1991; 122(6): 1617-1628.

Additional Files

Published

2015-03-31

Issue

Section

INTERNAL MEDICINE - PEDIATRICS