15 minutes later…
- Sinus rhythm with a ventricular rate of 81 bpm
- Normal PR interval (190 ms)
- Normal QRS axis (-24°)
- Normal QRS duration (86 ms)
- Normal R wave progression
- Resolution/normalisation of ST-segment elevation
- Normalisation of T-waves throughout
- Premature ventricular contractions (beat 3 & 7)
- Electrocardiographic changes consistent with a dynamic LAD lesion
- Emergent coronary angiogram revealed small vessel disease, in particular affecting LAD artery, but no significant lesion to explain ECG findings and elevation in hs-TnI.
- Diagnosed as coronary artery vasospasm and proceeded to medical management.