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Gepubliceerd in: Netherlands Heart Journal 10/2022

Open Access 10-05-2022 | Rhythm Puzzle – Question

Electrocardiographic ST-segment elevation with prominent R waves in precordial leads

Auteurs: A. Y. Andreou, A. R. Pérez-Riera

Gepubliceerd in: Netherlands Heart Journal | Uitgave 10/2022

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A 79-year-old man with a history suspicious of vasospastic angina presented after he had experienced angina at rest of approximately 10 min, which resolved spontaneously. Electrocardiography (ECG) recorded on admission—when he had no angina—showed atrial fibrillation, right bundle branch block and negative T waves of ischaemia in leads V2–V3 (Fig. 1). While the patient was still in the emergency department, he experienced another episode of angina, during which the ECG depicted in Fig. 2 was recorded. His angina resolved promptly following treatment with sublingual nitroglycerin, while the ECG changes returned to the pre-angina baseline state. Serum troponin I level was normal (< 0.5 ng/ml).
What is your diagnosis, and what could be the cause of the ECG abnormalities during the anginal episode?

Answer

You will find the answer elsewhere in this issue.

Funding

The authors received no specific funding for this work.

Conflict of interest

A.Y. Andreou and A.R. Pérez-Riera declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.
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Metagegevens
Titel
Electrocardiographic ST-segment elevation with prominent R waves in precordial leads
Auteurs
A. Y. Andreou
A. R. Pérez-Riera
Publicatiedatum
10-05-2022
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 10/2022
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-022-01692-w

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