ST segment elevation in leads V1 to V3 due to isolated right ventricular branch occlusion during primary right
Mahmut Acikel1, Mustafa Yilmaz, Engin Bozkurt
1Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey. macikel@atauni.edu.tr
Insights
ST segment elevation in anterior leads is rare with isolated right ventricular branch occlusion. This case highlights this unusual finding during myocardial infarction treatment.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Case Reports
Background:
- ST segment elevation in anterior leads typically indicates left anterior descending artery occlusion.
- Right ventricular myocardial infarction (MI) is often associated with inferior MI and right coronary artery (RCA) issues.
Observation:
- A rare case of acute inferior and right ventricular MI was observed.
- The patient presented with ST segment elevation in precordial leads V(1) to V(3).
Findings:
- The ST elevation in anterior leads was unexpectedly caused by an isolated occlusion of a right ventricular branch of the RCA.
- This occurred during primary percutaneous coronary intervention of the RCA.
Implications:
- This case expands the understanding of ST elevation patterns in myocardial infarction.
- It emphasizes the importance of considering atypical coronary artery anatomy and occlusion sites in interventional cardiology.
- Clinicians should be aware of this rare presentation to ensure accurate diagnosis and treatment.
Abstract:
It is rare to observe ST elevation in anterior derivations caused by isolated right ventricular branch occlusion. We described the case with acute inferior and right ventricular myocardial infarction (MI) who developed ST segment elevation in precordial leads V(1) to V(3) due to isolated right ventricular branch occlusion during primary right coronary angioplasty.
Related Concept Videos
01:24Cardiac Catheterization III: Left Heart Catheterization
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
01:21Cardiac Catheterization II: Right Heart Catheterization
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
01:21Coronary Circulation
The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
01:30Coronary Artery Disease I: Introduction
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...