Painless ischemia provoked by mental stress in the coronary care unit.
A 30-year-old man suffered a cardiac arrest after setting fire to his home. Continuous ST segment electrocardiographic monitoring in the Coronary Care Unit detected painless ST segment depression during an interview with a police officer. At angiography, the patient proved to have severe three-vessel coronary artery disease. This case demonstrates the clinical value of continuous ST segment monitoring in the ICU. In addition, the case illustrates that mental stress is a potential trigger for acute myocardial ischemia in the ICU.
Sharkey
S W
SW
Cardiology Division, Hennepin County Medical Center, Minneapolis, MN 55415, USA.
Aberg
N B
NB
Trost
L
L
Shear
W S
WS
D000328:Adult; D003325:Coronary Care Units; D004562:Electrocardiography; D005391:Firesetting Behavior / Q000523:psychology; D006323:Heart Arrest / Q000209:etiology / Q000523:psychology; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology