Acute coronary syndromes presenting with transient diffuse ST segment depression and ST segment elevation in lead aVR not caused by 'acute left main coronary artery occlusion': Description of two cases

摘要

Background Diffuse ST-segment depression in the inferior + anterolateral leads with ST-segment elevation in lead aVR has been described as characteristic of diffuse circumferential subendocardial ischemia caused by acute subtotal occlusion of the left main coronary artery. Methods Here we describe two patients admitted for acute neurological disorders who developed transient diffuse ST-segment depression in the inferior + anterolateral leads with ST-segment elevation in lead aVR, associated with elevation of cardiac troponin-I. Results In both cases subsequent coronary angiography did not show significant left main stenosis or "left main equivalent" narrowings. Conclusions As both patients had acute neurological disorders, a possible association between the two conditions is discussed.