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Figure 1 ECG and coronary flow patterns in a patient with reperfusion syndrome. Primary PTCA of the mid-LAD was performed 245 min after the onset of chest pain. Panel A: Electrocardiogram pattern. Thirty s after reperfusion, the patient complained of increased chest pain. The ECG obtained at that moment shows additional elevation of ST segment in leads V₂ to V₄: sum of ST segment elevation (ST) increased from 13 to 31 mm. Panel B: Flow velocity pattern in the distal LAD 10 min after successful PTCA. On-line flow velocity spectrum and time-averaged peak velocity (APV) are displayed on the top screen. Bottom left and right screens indicate base (BAPV = 19 cm/s) and adenosine-induced hyperemic (PAPV = 26 cm/s) APVs, respectively. Residual coronary velocity reserve (RATIO) is 1.3. ECG = electrocardiogram; LAD = left anterior descending coronary artery; PTCA = percutaneous transluminal coronary angioplasty.