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When coronary vasospasm causes an artery to undergo complete occlusion, an EKG might show evidence of ST-segment elevation in the leads indicative of that artery's territory. Transient ST-segment depression can also occur, usually in the setting of sub-total occlusion of an artery.
Complaints of chest pain should be immediately checked for an abnormal electrocardiogram (ECG). ECG changes compatible but not indicative of variant angina include elevations rather than depressions of the ST segment or an elevated ST segment plus a widening of the R wave to create a single, broad QRS complex peak termed the "monophasic curve". [4]
Rapid Interpretation of EKG's is a best-selling textbook for over 30 years [1] that teaches the basics of interpreting electrocardiograms. It adopts a simplistic fill-in-the-blank style [ 2 ] and is suited for medical students and junior residents. [ 1 ]
Ischemic cardiomyopathy is a type of cardiomyopathy caused by a narrowing of the coronary arteries which supply blood to the heart. [4] Typically, patients with ischemic cardiomyopathy have a history of acute myocardial infarction, [5] however, it may occur in patients with coronary artery disease, but without a past history of acute myocardial infarction.
Dubin practiced medicine in Tampa, Florida, [1] and gained fame within the medical community with the 1972 publication of Rapid Interpretation of EKG's, a best-selling textbook suited for medical students and junior residents. [2] In it, Dubin adopts a simplistic fill-in-the-blank style to teach the basics of reading electrocardiograms. [3]
Acute coronary syndrome is subdivided in three scenarios depending primarily on the presence of electrocardiogram (ECG) changes and blood test results (a change in cardiac biomarkers such as troponin levels): [4] ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina. [5]
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Vasospasm refers to a condition in which an arterial spasm leads to vasoconstriction. This can lead to tissue ischemia (insufficient blood flow) and tissue death ( necrosis ). Along with physical resistance, vasospasm is a main cause of ischemia.