Concerning EKG with a Non-obstructive angiogram. What happened?

CONCLUSION: Given resolution of severe CP in association with the above marked improvement of ST-T wave abnormalities in virtually all leads during the less than 1 hour between the recording of ECGs #1 and #2 — this strongly suggests reopening of a " culprit " vessel (whichever vessel this was)  — regardless of the fact that " no obstructive lesion was seen " at the time the cardiac catheterization happened to be done.The more than doubling of Troponin (even though " normal limits " for Troponin were not surpassed) — is consistent with a brief OMI, with only a short period of total occlusion.KEY Clinical Point about Comparison Tracings:Although I immediately noted the relative improvement in the degree of T-QRS-D between the 2 tracings in Figure-1  — I did not initially appreciate how marked the changes in ST-T wave morphology between the 2 tracings were in virtually all leads on these ECGs!It is ever-so-EASY to overlook serial ST-T wave changes if you simply review each tracing separately. Putting both tracings side-by-side (as I do in Figure-1)  — tremendously facilitates and expedites recognition of " real " differences in ST-T wave morphology — which given the associated resolution of CP in this case, proves that the cause of MINOCA in today ' s case was indeed, a transient acute OMI.Had additional...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs