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Asymptomatic coronary artery spasm with acute pathological ST elevation on routine ECG: Is it common?
  1. Ishaq Mohammed1,
  2. Mohamad Sadek El Zaatari2,
  3. Nikos Tyrogalas3,
  4. M I Khalid4
  1. 1Department of Cardiology/Medicine, West Midlands Deanery, Birmingham, UK
  2. 2Royal Shrewsbury Hospital, Shropshire, UK
  3. 3Leeds Infirmary, Leeds, UK
  4. 4Fairfield Hospital, Bury, UK
  1. Correspondence to Dr Ishaq Mohammed, limrishaq{at}


Asymptomatic spontaneous coronary artery spasm is rare and there are no case reports in literature presenting with acute ST elevation on routine ECG. We present the case of a 68-year-old Caucasian man who presented to a primary care physician for a routine ECG as part of hypertension follow-up. ECG revealed ST elevation in inferior leads II, III and aVF with reciprocal ST depression in leads I, aVL and also ST depression in anterior leads V1, V2 and V3 suggesting ongoing inferoposterior ST elevation myocardial infarction. The patient was completely well, stable and asymptomatic and he was rushed immediately to the coronary care unit via emergency ambulance. The patient was subjected to a battery of urgent investigations which were all normal. Also an urgent coronary angiogram was undertaken which showed completely normal coronary anatomy.

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