A Case of Acute Myocardial Infarction with Resolution of ST-Segment Elevation Immediately after Ventricular Defibrillation.
- Author:
Sung Kyun CHO
1
;
Yoon Jung KANG
;
Tae Hoon KIM
;
Hye Young LEE
;
Sung Woo CHO
;
Mee Won HWANG
;
Young Sup BYUN
Author Information
1. Division of Cardiology, Department of Internal Medicine, Sanggye-Paik Hospital, Inje University College of Medicine, Seoul, Korea. ysbyun@paik.ac.kr
- Publication Type:Case Report
- Keywords:
Angina pectoris, Variant;
Electric countershock;
Myocardial infarction;
Myocardial revascularization;
Ventricular fibrillation
- MeSH:
Accelerated Idioventricular Rhythm;
Adult;
Angina Pectoris, Variant;
Arteries;
Chest Pain;
Constriction, Pathologic;
Coronary Angiography;
Electric Countershock;
Electrocardiography;
Humans;
Myocardial Infarction;
Myocardial Revascularization;
Reperfusion;
Thrombosis;
Unconscious (Psychology);
Ventricular Fibrillation;
Vital Signs
- From:Korean Journal of Medicine
2011;80(6):708-711
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 38-year-old man presented with typical squeezing-type anterior chest pain. An initial electrocardiogram (ECG) showed prominent ST-segment elevation (V1-V4 lead, 3 mm). Suddenly, the patient fell unconscious and had no pulse. At that time, the ECG showed polymorphic ventricular fibrillation (VT). After direct current (DC) cardioversion, the patient regained vital signs and defibrillation converted the VT into an accelerated idioventricular rhythm with resolution of the ST-segment elevation. The patient was referred to our hospital for close observation and further evaluation. At our hospital, an ECG showed normal sinus rhythms and cardiac enzymes were within normal limits. We diagnosed the patient with variant angina rather than ST elevation myocardial infarction (STEMI), because his clinical manifestations were quite distinct; ST-segment elevations disappeared slowly at the reperfusion stage. However, the patient's final diagnosis was STEMI because coronary angiography showed severe eccentric tubular stenosis (85%) with remnant thrombus in the middle left anterior descending artery. Defibrillation likely removed the thrombus, which led to STEMI.
