open access

Vol 17, No 6 (2010)
Case Reports
Published online: 2010-12-08
Submitted: 2013-01-14
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Diffuse precordial ST-segment elevation in inferior-right myocardial infarction

Andreas Y. Andreou, Marios A. Ioannides, George M. Georgiou, Panayiotis C. Avraamides
Cardiol J 2010;17(6):628-631.

open access

Vol 17, No 6 (2010)
Case Reports
Published online: 2010-12-08
Submitted: 2013-01-14

Abstract

A right ventricular (RV) myocardial infarction (MI) may yield precordial ST-segment elevation (STE). Accordingly, combined inferior and precordial STE may be produced during an inferior-RV MI. Such an electrocardiographic picture may be mistakenly regarded as showing wrapped left anterior descending artery (LADA) occlusion or double vessel occlusion. We present a patient with inferior-RV MI and STE in the inferior, all precordial and right chest leads, in whom the diffuse precordial STE was probably mistakenly regarded as showing anterior MI. However, the STE resolution in V1-V2 and late R’ wave in V1, which were combined with a recanalized RV branch, favored the RV origin of this STE. Furthermore, the LADA was patent when V3-V6 showed severe ischemia, while its lesion was angiographically stable. Thus its simultaneous occlusion was unlikely. The late R’ wave in V1 indicates RV transmural conduction delay;as highlighted herein, it is diagnostic of a RV myocardial infarction. (Cardiol J 2010; 17, 6: 628-631)

Abstract

A right ventricular (RV) myocardial infarction (MI) may yield precordial ST-segment elevation (STE). Accordingly, combined inferior and precordial STE may be produced during an inferior-RV MI. Such an electrocardiographic picture may be mistakenly regarded as showing wrapped left anterior descending artery (LADA) occlusion or double vessel occlusion. We present a patient with inferior-RV MI and STE in the inferior, all precordial and right chest leads, in whom the diffuse precordial STE was probably mistakenly regarded as showing anterior MI. However, the STE resolution in V1-V2 and late R’ wave in V1, which were combined with a recanalized RV branch, favored the RV origin of this STE. Furthermore, the LADA was patent when V3-V6 showed severe ischemia, while its lesion was angiographically stable. Thus its simultaneous occlusion was unlikely. The late R’ wave in V1 indicates RV transmural conduction delay;as highlighted herein, it is diagnostic of a RV myocardial infarction. (Cardiol J 2010; 17, 6: 628-631)
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Keywords

myocardial infarction; ST elevation; transmural conduction delay

About this article
Title

Diffuse precordial ST-segment elevation in inferior-right myocardial infarction

Journal

Cardiology Journal

Issue

Vol 17, No 6 (2010)

Pages

628-631

Published online

2010-12-08

Bibliographic record

Cardiol J 2010;17(6):628-631.

Keywords

myocardial infarction
ST elevation
transmural conduction delay

Authors

Andreas Y. Andreou
Marios A. Ioannides
George M. Georgiou
Panayiotis C. Avraamides

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