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Challenges in Clinical Electrocardiography
February 3, 2020

An Unusual Cause of New Electrocardiographic ST-Segment Elevation

Author Affiliations
  • 1Shanghai Institute of Cardiovascular Diseases; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China
JAMA Intern Med. Published online February 3, 2020. doi:10.1001/jamainternmed.2019.7083

An older woman with a history of diabetes and paroxysmal atrial fibrillation presented with sudden-onset chest pain. The electrocardiogram (ECG) on arrival demonstrated ST-segment elevation (STE) in the inferior and posterior leads (Figure, at presentation), and the initial high-sensitive troponin T level was 0.309 ng/mL (reference range, 0.00-0.03 ng/mL). On physical examination, her vital signs showed a normal heart rate and blood pressure. She was hesitant to undergo emergency coronary angiography.

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