Related Experiment Video

Updated: Jun 1, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

A common electrocardiographic finding in an uncommon presentation

Amr Mohsen1, Abdelkader Almanfi, Mohammad Otahbachi

  • 1Department of Medicine, George Washington University, Washington, DC, USA. Mohsen@gwu.edu

The Journal of Invasive Cardiology
|June 8, 2011
PubMed

Insights

Marked ST-segment elevation in precordial leads, typically indicating left ventricular infarction, can rarely result from right coronary artery (RCA) branch occlusion causing isolated right ventricular myocardial infarction (RVMI). Prompt recognition is vital for appropriate patient management.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diagnostic Electrocardiography

Background:

  • Anterior ST-segment elevation on electrocardiography (ECG) typically signifies acute anterior left ventricular infarction due to left coronary artery occlusion.
  • Right ventricular myocardial infarction (RVMI) often presents with inferior ST-segment elevation.

Observation:

  • A rare case presented with marked ST-segment elevation in precordial leads and concomitant inferior ST-segment elevation.
  • This ECG pattern was caused by acute occlusion of the marginal branches of the right coronary artery (RCA).
  • The occlusion resulted from an iatrogenic spiral dissection during coronary angioplasty, requiring stenting of the RCA.

Findings:

  • Diffuse ST-segment elevation in precordial leads can be an indicator of right coronary artery (RCA) or its branch occlusion.
  • This specific case demonstrated an isolated right ventricular myocardial infarction (RVMI) secondary to RCA marginal branch occlusion.
  • The diagnosis was confirmed during coronary angioplasty procedures.

Implications:

  • Recognizing diffuse precordial ST-segment elevation due to RCA occlusion is crucial for differentiating from left ventricular infarction.
  • Management strategies for RVMI differ significantly from left ventricular myocardial infarction, emphasizing preload maintenance and avoiding vasodilators.
  • This case highlights the importance of considering atypical presentations of myocardial infarction and the potential complications of interventional procedures.

More Related Videos

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction06:57

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

Related Concept Videos

Electrocardiogram01:29

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
Electrocardiogram Fundamentals01:28

Electrocardiogram Fundamentals

Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin to...
Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.
Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...