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Updated: Jan 23, 2026

Acute Myocardial Infarction in Rats
Published on: February 16, 2011
Acute Isolated Right Ventricular Infarction: Unusual Presentation of Anterior ST-Segment-Elevation Myocardial
Insights
Unusual right ventricular myocardial infarction can mimic anterior ST-segment elevation. Prompt diagnosis via electrocardiogram and coronary angiography is crucial for timely intervention and improved outcomes.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Interventional Cardiology
Background:
- ST-segment elevation in anterior precordial leads (V1-V2) typically indicates left anterior descending coronary artery occlusion.
- Right ventricular myocardial infarction (RVMI) diagnosis can be challenging due to atypical electrocardiogram (ECG) presentations.
Abstract:
Acute right ventricular infarction presenting with ST-segment elevation in the anterior precordial electrocardiographic leads is an unusual event. Anterior ST-segment elevation typically suggests occlusion of the left anterior descending coronary artery. It should be recognized, however, that occlusion of a right coronary artery branch can cause isolated ST-segment elevation in leads V1 and V2 on a standard 12-lead electrocardiogram. We describe the cases of 2 patients who presented with acute chest syndrome with isolated ST-segment elevation in leads V1 and V2. Emergency coronary angiograms revealed that acute thrombotic occlusion of the right ventricular marginal branch of the dominant right coronary artery caused the clinical manifestations in the first patient, whereas occlusion of the proximal nondominant right coronary artery was the culprit lesion in the second patient. Both lesions caused right ventricular myocardial infarction. The patients underwent successful primary percutaneous coronary intervention. These cases illustrate the importance of carefully reviewing angiographic findings to accurately diagnose an acute isolated right ventricular myocardial infarction, which may mimic the electrocardiographic features of an anterior-wall myocardial infarction.
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