Inferolateral ST elevation as a first sign of left anterior descending artery occlusion.
Combined anterior and inferior ST elevation due to occlusion of wrapped left anterior descending artery (LAD) is well reported in the literature. However, there is rare literature mentioned about inferolateral ST elevation in this patient group. Herein, we report a case of acute proximal wrapped LAD occlusion with initial electrocardiographic sign of inferolateral ST elevation. The most likely mechanism of this electrocardiographic finding might be related to old anteroseptal myocardial infarction, combination with other coronary abnormality, such as chronic total occlusion of left circumflex artery that caused larger injury current in inferolateral than anteroseptal myocardium, and made anteroseptal leads reveal isoelectric pattern.
Department of Internal Medicine, Division of Cardiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Po-Chao
PC
Hsu
Tsung-Hsien
TH
Lin
Ho-Ming
HM
Su
Wen-Chol
WC
Voon
Wen-Ter
WT
Lai
Sheng-Hsiung
SH
Sheu
D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000628:therapy; D017023:Coronary Angiography / Q000379:methods; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D015912:Thrombolytic Therapy / Q000379:methods