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.