A patient with simultaneous anterior and inferior ST-segment elevation after percutaneous coronary intervention.

Research paper by Andreas Y AY Andreou, Zeinab Al Hawraa ZAH Atieh, Alisa Thuy Anh ATA Pham

Indexed on: 03 Sep '19Published on: 02 Sep '19Published in: Journal of Electrocardiology


A patient who presented with acute inferior-right ventricular (RV) ST-segment elevation (STE) myocardial infarction (MI) is described. Coronary angiography showed a mid-right coronary artery (RCA) occlusion and high-grade proximal left anterior descending (LAD) artery stenoses. Electrocardiography (ECG) after stent angioplasty to the RCA showed new STE in leads V1-V6. Whereas STE pattern recognition was misleading, ECG analysis using vector concepts enabled exclusion of anterior MI due to proximal LAD artery occlusion and recognition of the RV origin of this ECG picture. The ability of the ECG to "capture" RV dilation that enabled the manifestation of this ECG picture is highlighted. Copyright © 2019 Elsevier Inc. All rights reserved.