ST-depression in right precordial leads with inferior STEMI and occluded right coronary artery: intertwined anatomy and ischemic areas

被引：2

作者：

De Gennaro, Luisa ^{[1
]}

Brunetti, Natale Daniele ^{[2
]}

Ruggiero, Massimo ^{[1
]}

Rutigliano, David ^{[1
]}

Locuratolo, Nicola ^{[1
]}

Di Biase, Matteo ^{[2
]}

Caldarola, Pasquale ^{[1
]}

机构：

[1] Osped San Paolo, Dept Cardiol, Bari, Italy

[2] Univ Foggia, Dept Cardiol, Viale Pinto 1, I-71100 Foggia, Italy

来源：

ACTA CLINICA BELGICA | 2017年 / 72卷 / 05期

关键词：

Right precordial leads ST-depression; Inferior ST-elevation acute myocardial infarction; ACUTE MYOCARDIAL-INFARCTION; LEFT CIRCUMFLEX; ELECTROCARDIOGRAPHY; OCCLUSION; SALVAGE;

D O I：

10.1080/17843286.2016.1246097

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Right coronary artery (RCA) occlusion in inferior acute myocardial infarction is usually heralded by ST-elevation both in inferior and in right precordial leads. We report the case of a 68-year-old male, who presented marked ST-elevation in inferior leads, mirrored by ST-depression in anterior-septal and lateral leads. Right precordial lead electrocardiogram unexpectedly showed ST-depression V1R-V5R leads. Coronary angiography showed mid-left anterior descending (LAD) coronary near-complete occlusion with distal wrapping LAD. Left circumflex artery was not occluded, while RCA was occluded mid tract. The patient was treated with coronary angioplasty on RCA and LAD. Absence of ST-elevation in right precordial leads may be presumably explained by the presence of a large ischemic area distal to mid-LAD near-occlusive stenosis and of a long-wrapping LAD. Complex coronary anatomy and intertwined ischemic areas may underlie apparently discording electrocardiograms.

引用

页码：340 / 342

页数：3

共 10 条

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