title: Exercise-induced S-T segment elevation in variant angina.
abstract: Five patients with known ischemic heart disease had an unusual pattern of S-T segment depression during treadmill exercise testing followed by S-T segment elevation and chest pain in the postexercise period. Thallium-201 scintigraphy revealed reversible exercise-induced myocardial ischemia, in areas supplied by severely narrowed coronary arteries as documented by coronary arteriography. Ambulatory electrocardiographic recording for S-T segment shift using a frequency-modulated system showed S-T segment depressions and elevations at rest in the same leads that showed similar shifts during exercise tests. Three of the five patients had a myocardial infarction within 8 weeks of diagnosis, and two died. This syndrome may be associated with severe coronary artery disease and may have a very poor prognosis.
mesh_terms: D000553:Ambulatory Care; D000787:Angina Pectoris / Q000175:diagnosis*; D000788:Angina Pectoris, Variant / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013793:Thallium; D014700:Verapamil / Q000627:therapeutic use
chemical_list: D011868:Radioisotopes; D013793:Thallium; D014700:Verapamil