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Right ventricular infarction mimicking anterior infarction.

Manolis Vavuranakis¹, Maria Drakopoulou, Konstantinos Toutouzas

¹1st Department of Cardiology, Hippokration Hospital, University of Athens, Greece. mvav@otenet.gr

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc

|April 25, 2006

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ST elevation in anterior leads is rare with right ventricular branch occlusion. This case highlights acute right ventricular myocardial infarction from right coronary artery occlusion, emphasizing the need for accurate diagnosis due to differing treatments.

Area of Science:

Cardiology
Diagnostic Electrocardiography

Background:

ST-segment elevation in anterior precordial leads (V1-V4) typically suggests anterior myocardial infarction.
Right ventricular myocardial infarction (RVMI) commonly presents with ST elevation in inferior leads (II, III, aVF).

Observation:

A patient with unstable angina developed acute RVMI with ST elevation in anterior leads (V1-V4) post-coronary angiography.
Coronary angiography revealed a total occlusion of the right coronary artery (RCA) proximal to its right ventricular branch.

Findings:

Diffuse ST-segment elevation in precordial leads can indicate acute RCA occlusion, not solely anterior wall infarction.
This presentation is an uncommon but critical electrocardiographic finding.

Implications:

Related Experiment Videos

Accurate differentiation between anterior myocardial infarction and RVMI due to RCA occlusion is crucial.
Timely and correct diagnosis is essential as therapeutic strategies differ significantly for these conditions.