Nonmechanical ST-Segment Alternans in Prinzmetal's Angina

Brief Reports1 July 1978Nonmechanical ST-Segment Alternans in Prinzmetal's AnginaJOHN J. ROZANSKI, M.D., JOSE MELLER, M.D., MORRIS KLEINFELD, M.D., F.A.C.P., AGUSTIN CASTELLANOS, M.D., F.A.C.P., JOEL KUPERSMITH, M.D., F.A.C.P.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., JOEL KUPERSMITH, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-89-1-76 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe 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...References1. KLEINFELDROZANSKI MJ: Alternans of the ST segment in Prinzmetal's angina. Circulation 55:574-577, 1977 CrossrefMedlineGoogle Scholar2. ROZANSKIKLEINFELD JM: ST segment alternans in Prinzmetal's angina and associated ventricular arrhythmias (abstract). Circulation 54:II-77, 1976 Google Scholar3. ROSELLECRAMPTONCASE HRR: Alternans of the depressed ST segment during coronary insufficiency. Am J Cardiol 18:200-207, 1966 CrossrefMedlineGoogle Scholar4. NIARCHOS A: Electrical alternans in cardiac tamponade. Thorax 30:228-233, 1975 CrossrefMedlineGoogle Scholar5. HAN J: Mechanisms of ventricular arrhythmias associated with myocardial infarction. Am J Cardiol 24:800-813, 1969 CrossrefMedlineGoogle Scholar6. SCHWARTZMALLIANI PA: Electrical alternation of the T wave: clinical and experimental evidence of its relationship with the sympathetic nervous system and with the long Q-T syndrome. Am Heart J 89:45-50, 1975 CrossrefMedlineGoogle Scholar7. BASHOURRIOSGORMAN TJP: U wave alternans and increased ventricular irritability. Chest 64:377-379, 1973 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Mount Sinai School of Medicine of the City University of New York New York, New York The University of Miami School of Medicine Miami, Florida PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByVasospastic AnginaRepolarization Aiternans: Techniques, Mechanisms, and Cardiac VulnerabilityElectrophysiologic Basis for T Wave Alternans as an Index of Vulnerability to Ventricular FibrillationAlternans of the ST Segment in Variant AnginaElectrical alternans and cardiac electrical instability.ST Segment Alternans in Vasospatic AnginaAuthor's ReplyCoronary artery spasm: Demonstration, definition, diagnosis, and consequencesAlternans of the ST Segment and T Wave. A Sign of Electrical Instability in Prinzmetal's AnginaLETTERS TO EDITORTQ Segment (Baseline) Alternans during PrinzmetaPs Variant AnginaElectrical Alternans of the ST Segment in Non-PrinzmetaPs AnginaRelation of coronary arterial spasm to sites of organic stenosisCoronary Artery SpasmROBERT J. LUCHI, M.D., ROBERT A. CHAHINE, M.D., ALBERT E. RAIZNER, M.D. 1 July 1978Volume 89, Issue 1Page: 76-77KeywordsAnginaArrhythmiaBloodElectrocardiographyHeartLungsMedical servicesMyocardial infarction Issue Published: 1 July 1978 PDF DownloadLoading ...