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Patient
63-year-old woman, smoker, hospitalized for multiple episodes of chest pain occurring in the morning at rest and ceasing under Nitroglycerine spray; hospitalization and recording of a tracing during pain;
Trace
This electrocardiogram recorded during pain shows sinus rhythm, left atrial enlargement and ST-segment elevation from V1 to V4 with minimal reciprocity in the inferior leads;
Trace
Recorded after administration of 2 puffs of sublingual nitroglycerine; this tracing shows a progressive decrease in the amplitude of the elevation concomitant with the resolution of thoracic pain;
Trace
Tracing recorded in continuity of the previous ECG; disappearance of ST-segment elevation and inversion of T-waves;
Exergue
An elevation of significant amplitude is the characteristic electrocardiographic sign observed during a Prinzmetal's angina attack. This elevation whose topography depends on the artery presenting the spasm, can begin at the peak of the R wave, encompass the T-wave and constitute a monophasic dome-shaped wave.
This patient presented with Prinzmetal's angina with evidence of a non-significant LAD stenosis with objectivation of a spasm induced by the injection of Methergin.