Literature Review: mechanisms of acute coronary syndromes (ACS) and the problems with stress testing and coronary angiography

Emergency Cardiology Literature Review & Updates with Dr. Amal Mattu


A 36-year-old male with history of tobacco use presents to the ED with acute chest pain. He was recently admitted to the hospital for chest pain and had a negative Myoview stress test. He is back with recurrent chest pain. The following ECG is obtained:

Before watching the video, look closely at this ECG and ask yourself these questions:

  1. What ECG abnormalities do you see?
  2. What is the most likely cause?
  3. Is it possible to have acute MI after a recent negative stress test or unremarkable coronary angiogram?