title: 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.
abstract: 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.
authors.affiliation: Section of Cardiology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Kim
authors.forename: Yochai
authors.initials: Y
authors.lastname: Birnbaum
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D054059:Coronary Occlusion; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications