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Isolated Right Ventricular Infarction Mimicking Anterior ST-Segment Elevation

Onur Baydar1, Veysel Oktay1, Ugur Coskun1

  • 1Instructor, Department of Cardiology, Institute of Cardiology, Istanbul University , Istanbul, Turkey .

Journal of Clinical and Diagnostic Research : JCDR
|May 19, 2016
PubMed

Insights

Anterior ST-segment elevation typically signals left anterior descending artery occlusion. This rare case highlights isolated right ventricular myocardial infarction presenting with anterior ST-segment elevation due to right coronary artery occlusion.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Myocardial Infarction

Background:

  • ST-segment elevation in anterior precordial leads usually indicates left anterior descending coronary artery occlusion in acute coronary syndromes.
  • Anterior ST-segment elevation has been an atypical but recognized presentation of right ventricular myocardial infarction (RVMI).
  • RVMI is often associated with occlusion of the right coronary artery (RCA).

Observation:

  • This report details a rare case of isolated RVMI.
  • The patient presented with ST-segment elevation in the anterior precordial leads.
  • This electrocardiographic pattern was attributed to a proximal occlusion of the right coronary artery.

Findings:

  • Primary percutaneous coronary angioplasty and stenting of the occluded right coronary artery were successfully performed.
  • The intervention led to the resolution of chest pain.
  • The ST-segment elevation on the electrocardiogram also resolved post-intervention.

Implications:

  • This case underscores the importance of considering RVMI in patients presenting with anterior ST-segment elevation, even when isolated.
  • It highlights the potential for right coronary artery occlusion to manifest with atypical electrocardiographic findings.
  • Successful primary percutaneous coronary angioplasty for such cases can effectively restore myocardial perfusion and alleviate symptoms.

Keywords:
Coronary angioplastyMyocardial infarctionRight ventricle

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