Stress-induced ST-segment elevation in patients without prior Q-wave myocardial infarction

Roy Beinart, Shlomi Matetzky, Michael Shechter, Paul Fefer, Eli Rozen, Tal Beinart, Hanoch Hod, Pierre Chouraqui*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Stress-induced ST-segment elevation is an uncommon finding that usually occurs in patients with prior myocardial infarction (MI). Our purpose was to assess the angiographic and clinical significance of this finding in patients without prior MI. Methods: Of the 29 002 consecutive ambulatory patients who underwent stress myocardial perfusion imaging over a 5-year period, 205 (0.7%) developed stress-induced ST-segment elevation, of whom 39 (19%) had no Q-wave MI in leads showing ST-segment elevation during either exercise (n = 31) or dipyridamole (n = 8) stress myocardial perfusion imaging. All 39 patients were hospitalized and underwent coronary angiography. Results: Significant coronary artery disease was found in all 39 patients: 87% had critical (≥90%) stenosis, and 59% had multiple vessel disease. During hospitalization, 37 patients (95%) underwent revascularization. Conclusions: In patients without prior Q-wave MI, stress-induced ST-segment elevation is associated with critical coronary artery disease. Therefore, these patients should be considered for early coronary investigation.

Original languageEnglish
Pages (from-to)312-317
Number of pages6
JournalJournal of Electrocardiology
Volume41
Issue number4
DOIs
StatePublished - Jul 2008

Keywords

  • Critical coronary artery disease
  • ST-segment elevation
  • Stress test

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