Electrocardiographical case. An elderly lady with chest pain. Diagnosis: isolated posterior myocardial infarct (MI).
A 72-year-old woman with diabetes mellitus, hypertension and dyslipidaemia presented with severe chest pain of four hours duration. Her electrocardiogram (ECG) showed tall R waves in leads V1-2, and ST segment depression in leads V1- 4, consistent with an isolated posterior myocardial infarction (MI). Emergency coronary angiogram showed an occluded left circumflex coronary artery, and primary angioplasty and stenting was performed. The ECG criteria for isolated posterior MI and pitfalls in using the conventional 12-lead ECG are discussed.
Chiam
P
P
Department of Cardiology, National Heart Centre, Mistri Wing, 17 Third Hospital Avenue, Singapore 168752. paul_chiam@nhc.com.sg
Chuah
S C
SC
Wong
P
P
Teo
W S
WS
D000368:Aged; D002637:Chest Pain / Q000209:etiology*; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000628:therapy