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Isolated right ventricular infarction presenting with anterior ST-segment elevation: a case for careful assessment of

Sérgio Nabais1, Victoria Martin-Yuste, Monica Masotti

  • 1Interventional Cardiology Section, Cardiology Department, Thorax Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. sergionnabais@gmail.com

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|March 20, 2012
PubMed

Insights

This case report details a rare instance of isolated right ventricular infarction causing anterior ST-segment elevation, successfully treated with primary percutaneous coronary intervention. It emphasizes the importance of identifying right ventricular branch occlusion in diagnosing anterior ST-elevation myocardial infarction.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diagnostic Imaging

Background:

  • Anterior ST-segment elevation myocardial infarction (STEMI) typically involves the left anterior descending artery.
  • Isolated right ventricular infarction is an uncommon diagnosis that can mimic anterior STEMI.
  • Codominant right coronary artery systems present unique anatomical considerations in myocardial infarction.

Observation:

  • A 61-year-old male presented with chest pain and anterior ST-segment elevation (leads V1-V5).
  • Angiography revealed a proximal occlusion of the right ventricular branch of a codominant right coronary artery.
  • The patient underwent primary percutaneous coronary intervention (PCI) of the affected branch.

Findings:

  • PCI resulted in successful revascularization of the right ventricular branch.
  • Resolution of chest pain and ST-segment elevation was observed post-procedure.
  • This case represents isolated right ventricular myocardial infarction due to a specific coronary artery branch occlusion.

Implications:

  • Highlights the significance of considering isolated right ventricular infarction in anterior STEMI differential diagnoses.
  • Underscores the critical role of meticulous angiographic review to identify culprit lesions in less common coronary territories.
  • Presents the first reported case of successful primary PCI for isolated acute right ventricular myocardial infarction secondary to right ventricular branch occlusion.

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