PAINLESS ISCHEMIA PROVOKED BY MENTAL STRESS IN THE CORONARY-CARE UNIT

A 30-year-old man suffered a cardiac arrest after setting fire to his home. Continuous ST segment eletrocardiographic monitoring in the Coro nary Care Unit detected painless ST segment depression during an inter view with a police officer. At angiography, the patient proved to have severe three-vessel coronary artery disease. This case demonstrates t he clinical value of continuous ST segment monitoring in the ICU. In a ddition, the case illustrates that mental stress is a potential trigge r for acute myocardial ischemia in the ICU.