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Nonmechanical ST-Segment Alternans in Prinzmetal's Angina
- JOHN J. ROZANSKI, M.D.;
- JOSE MELLER, M.D.;
- MORRIS KLEINFELD, M.D., F.A.C.P.;
- AGUSTIN CASTELLANOS, M.D., F.A.C.P.; and
- JOEL KUPERSMITH, M.D., F.A.C.P.
- Mount Sinai School of Medicine of the City University of New York; New York, New York; and The University of Miami School of Medicine; Miami, Florida
Excerpt
The phenomenon of electrical alternans of the ST segment during periods of ST elevation in Prinzmetal's angina is of great clinical interest. In our experience it appears to be a sign in the surface electrocardiogram (ECG) reflecting an unstable electrical state frequently heralding serious ventricular arrhythmias (1, 2). Occurring in about 30% of all episodes of Prinzmetal's angina (1, 2), but never observed during ST elevation of an evolving myocardial infarction, it appears to be highly specific for Prinzmetal's angina in humans. Its occurrence may thus allow distinction between the two conditions at the bedside. The phenomenon of ST alternans
Acknowledgments
The authors acknowledge the wise counsel of Richard Gor-lin, M.D.; Robert J. Myerburg, M.D.; Ralph Lazzara, M.D.; and Nabil El-Sherif, M.D.
Article and Author Information
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Grant support: In part by Grants HL 10833-02 and HL 18801 of the National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Public Health Service.
