Long-term analgesic use: Sometimes less is not more

摘要

Much attention has recently been given to the use of ST-segment elevation (STE) in electro-cardiographic lead aVR in the setting of acute coronary syndromes as indicative of left main and/or proximal left anterior descending coronary artery disease.1 It must be remembered, however, that STE in lead aVR is not specific for these coronary findings. While Na-kamura et al1 discuss a differential diagnosis in their "Comment" section, they fail to mention one of the most common causes of STE in lead aVR, which is left ventricular (LV) hypertrophy.