Inferolateral Infarction or Prinzmetal Angina?

Report:

Sinus tachycardia 112/min

Acute inferolateral infarction

Comment:

Again, like in the previous example, one would have to report infarction. This time however it was documented spasm in a cocaine addict. The artery was probably left circumflex, given the absence of reciprocal depression in lead 1 and the involvement of the anterolateral28 leads. The ECG rapidly normalised (Fig 33a) with nitrates and there was no rise in the cardiac injury markers.

He also had Staphylococcus aureus septicæmia. Sepsis is another cause of ST elevation29 which, unlike transient spasm, usually has a rise in biomarkers. Staphylococcal endocarditis with embolism would cause true infarction.

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