title: [Combined anterior and inferior ST-segment elevation during exercise test: a case report].
abstract: Exercise-induced ST-segment elevation without Q waves is a rare situation. Its frequent causes are slow coronary flow leading to serious myocardial ischemia, significant coronary stenosis, and coronary vasospasm. Effort-related combined anterior and inferior ST elevation is even rarer. A 49-year-old man was admitted with exercise-induced chest pain. During exercise stress test, he developed typical retrosternal chest pain with combined anterior and inferior ST elevation on electrocardiography. Coronary angiography showed an anomalous left circumflex coronary artery arising from the right sinus of Valsalva. A plaque and diffuse spasm were noted in the middle portion of the left anterior descending coronary artery. Intracoronary nitroglycerin administration resulted in complete resolution of the spasm. The patient was discharged on medical therapy.
authors.affiliation: Department of Cardiology, Konya Numune Hospital, Konya, Turkey. draribas@hotmail.com
authors.forename: Alpay
authors.initials: A
authors.lastname: Aribaş
authors.forename: Mustafa Asim
authors.initials: MA
authors.lastname: Sarigüzel
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ozdil
mesh_terms: D000787:Angina Pectoris / Q000209:etiology*; D017023:Coronary Angiography; D023921:Coronary Stenosis; D003329:Coronary Vasospasm / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000627:therapeutic use; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin