Title : Transient ST-elevation MI diagnosed by holter monitoring
Abstract:
Presentation: A 54-year-old woman was referred with an 8-week history of pressure sensations over the chest and epigastrium unrelated to exertion. She presented to the Emergency Department 4 weeks prior but self-discharged against medical advice due to the long wait time.
Diagnosis: ECG revealed T wave inversion in leads III & aVF, and transthoracic echocardiogram showed normal ventricular systolic function. A 24-hour Holter monitor was performed due to cardiac risk factors to investigate for arrhythmias. Results revealed episodes of ST elevation which correlated with the patient’s recorded events. Coronary angiography demonstrated 99% stenosis in the right coronary artery.
Treatment: Percutaneous coronary intervention was performed and the patient was started on dual-antiplatelet therapy, statin, and betablocker. Anginal episodes resolved immediately.
Conclusion: ST changes on Holter readings may be of diagnostic benefit and warrant further assessment.
