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Updated: Feb 6, 2026

Acute Myocardial Infarction in Rats
Published on: February 16, 2011
Combined ST Elevation in a Case of Acute Myocardial Infarction: How to Identify the Infarct-related Artery?
Kavitha Balasubramanian1, Balasubramanian Ramachandran1, Anandaraja Subramanian2
1Department of General Medicine, Indira Gandhi Medical College & Research Institute, Puducherry, India.
Abstract:
Combined ST elevation in anterior and inferior ECG leads in acute myocardial infarction is not a rarity. It is both interesting and challenging to indentify the infarct related culprit artery. We report the case of a middle aged male with acute myocardial infarction whose admission ECG shows ST elevation in lead II, III, aVF as well as from V1-V3. 90% of such cases are due to single vessel occlusion - majority due to proximal RCA occlusion and the remaining due to mid to distal LAD occlusion. ECG features to differentiate between these two vascular occlusions are discussed. In this case at hand, lead III ST elevation of 2.5 mm and V2/V3≥ 1 indicates proximal RCA as the IRA and the same has been confirmed by pre-discharge coronary angiogram .
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