Cas du mois Juillet 2022 - Rythmologie-


ST elevation after an atrial fibrillation : what to do?

A 37 year-old-man who suffered from acute palpitation and intermittent atypical chest pain . As a medical history, he had noticed a similar episode of palpitation .He had any cardiovascular risk factor. On examination there was no fever. Heart rate was 122 initially and blood pressure was  130/80 mmHg. No signs of heart failure were present. The  first electrocardiogram found an atrial fibrillation rhythm with presence of a doublet of premature ventricular complex,  no repolarization abnormalities were noticed (Fig1)  . A control electrocardiogram was done revealing a spontaneous return to sinusal rhythm with a clear ST  segment elevation  in the septo-apico-lateral  and inferior derivations and a PQ segment depression in lateral derivations (Fig 2).  the patient was out chest pain.Trans thoracic echography revealed a normal left ventricular function , the absence of valvular diseases, the absence of pericardial effusion and wall motion abnormalities,LA was normal . Lab tests notice essentially negative troponins and negative inflammation markers.


What is second step?