Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery?

Combined ST elevation in anterior and inferior ECG leads in acute myocardial infarction is not a rarity. It is both interesting and challenging to indentify the infarct related culprit artery. We report the case of a middle aged male with acute myocardial infarction whose admission ECG shows ST elev...

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Autores principales: Balasubramanian, Kavitha, Ramachandran, Balasubramanian, Subramanian, Anandaraja, Balamurugesan, Kandan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081999/
https://www.ncbi.nlm.nih.gov/pubmed/30123751
http://dx.doi.org/10.4103/ijabmr.IJABMR_365_16
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author Balasubramanian, Kavitha
Ramachandran, Balasubramanian
Subramanian, Anandaraja
Balamurugesan, Kandan
author_facet Balasubramanian, Kavitha
Ramachandran, Balasubramanian
Subramanian, Anandaraja
Balamurugesan, Kandan
author_sort Balasubramanian, Kavitha
collection PubMed
description Combined ST elevation in anterior and inferior ECG leads in acute myocardial infarction is not a rarity. It is both interesting and challenging to indentify the infarct related culprit artery. We report the case of a middle aged male with acute myocardial infarction whose admission ECG shows ST elevation in lead II, III, aVF as well as from V(1)-V(3). 90% of such cases are due to single vessel occlusion - majority due to proximal RCA occlusion and the remaining due to mid to distal LAD occlusion. ECG features to differentiate between these two vascular occlusions are discussed. In this case at hand, lead III ST elevation of 2.5 mm and V(2)/V(3)≥ 1 indicates proximal RCA as the IRA and the same has been confirmed by pre-discharge coronary angiogram .
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spelling pubmed-60819992018-08-17 Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery? Balasubramanian, Kavitha Ramachandran, Balasubramanian Subramanian, Anandaraja Balamurugesan, Kandan Int J Appl Basic Med Res Case Report Combined ST elevation in anterior and inferior ECG leads in acute myocardial infarction is not a rarity. It is both interesting and challenging to indentify the infarct related culprit artery. We report the case of a middle aged male with acute myocardial infarction whose admission ECG shows ST elevation in lead II, III, aVF as well as from V(1)-V(3). 90% of such cases are due to single vessel occlusion - majority due to proximal RCA occlusion and the remaining due to mid to distal LAD occlusion. ECG features to differentiate between these two vascular occlusions are discussed. In this case at hand, lead III ST elevation of 2.5 mm and V(2)/V(3)≥ 1 indicates proximal RCA as the IRA and the same has been confirmed by pre-discharge coronary angiogram . Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6081999/ /pubmed/30123751 http://dx.doi.org/10.4103/ijabmr.IJABMR_365_16 Text en Copyright: © 2018 International Journal of Applied and Basic Medical Research http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Balasubramanian, Kavitha
Ramachandran, Balasubramanian
Subramanian, Anandaraja
Balamurugesan, Kandan
Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery?
title Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery?
title_full Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery?
title_fullStr Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery?
title_full_unstemmed Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery?
title_short Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery?
title_sort combined st elevation in a case of acute myocardial infarction: how to identify the infarct-related artery?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081999/
https://www.ncbi.nlm.nih.gov/pubmed/30123751
http://dx.doi.org/10.4103/ijabmr.IJABMR_365_16
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