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Simultaneous inferior and anterior infarction or severe right ventricular involvement?

  • Karl FenglerEmail author
  • R. Palitzsch
  • S. Desch
  • H. Thiele
Letter to the Editors
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Sirs:

In acute myocardial infarction, 12-lead electrocardiogram (ECG) usually allows attribution of the infarct territory to the ‘culprit’ coronary vessel. In some cases, an altered cardiac anatomy in the left hemithorax or of coronary arteries can hinder this correlation and be misleading to clinicians [1, 2]. We present a case of inferior ST-elevation myocardial infarction with newly diagnosed ST-elevation in anterior leads after PCI of the right coronary artery (RCA).

A 62-year-old man was admitted to our hospital for acute coronary syndrome with persistent angina pectoris for approximately 9 h and possible signs of Q-wave infarction and borderline-significant ST-elevation in preclinical ECG-leads III and aVF (Fig. 1, 1st column).

Keywords

Right-heart infarction Cardiac magnetic resonance imaging ST-elevation myocardial infarction Electrocardiogram 

Notes

Funding

No external financial support was received for this case report.

Compliance with ethical standards

Conflict of interest

The authors state that they have no conflict of interest to declare.

References

  1. 1.
    Hurst JW (1998) Comments about the electrocardiographic signs of right ventricular infarction. Clin Cardiol 21(4):289–291CrossRefGoogle Scholar
  2. 2.
    Porter A, Herz I, Strasberg B (1997) Isolated right ventricular infarction presenting as anterior wall myocardial infarction on electrocardiography. Clin Cardiol 20(11):971–973CrossRefGoogle Scholar
  3. 3.
    Matte BDS, Azmus AD (2017) Acute myocardial infarction caused by an anomalous right coronary artery occlusion presenting with precordial ST elevation. Case Rep Cardiol 2017:3972830.  https://doi.org/10.1155/2017/3972830 Google Scholar
  4. 4.
    Walsh B, Grauer K, Tuohy ER, Smith SW (2018) Proximal RCA occlusion producing anterior ST segment elevation, Q waves, and T wave inversion. J Electrocardiol 51(3):511–515.  https://doi.org/10.1016/j.jelectrocard.2017.12.036 CrossRefGoogle Scholar
  5. 5.
    Koh TW, Coghlan JG, Lipkin DP (1996) Anterior ST segment elevation due to isolated right ventricular infarction during right coronary angioplasty. Int J Cardiol 54(3):201–206CrossRefGoogle Scholar
  6. 6.
    Kanovsky J, Kala P, Novotny T, Benesova K, Holicka M, Jarkovsky J, Koc L, Mikolaskova M, Ondrus T, Malik M (2016) Association of the right ventricle impairment with electrocardiographic localization and related artery in patients with ST-elevation myocardial infarction. J Electrocardiol 49(6):907–910.  https://doi.org/10.1016/j.jelectrocard.2016.08.001 CrossRefGoogle Scholar
  7. 7.
    DePace NL, Colby J, Hakki AH, Manno B, Horowitz LN, Iskandrian AS (1983) Poor R wave progression in the precordial leads: clinical implications for the diagnosis of myocardial infarction. J Am Coll Cardiol 2(6):1073–1079CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Karl Fengler
    • 1
    Email author
  • R. Palitzsch
    • 1
  • S. Desch
    • 1
  • H. Thiele
    • 1
  1. 1.Department of Internal Medicine/CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany

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