Rare and Fascinating Case of ST-Elevation Myocardial Infarction Diagnosis From an Underlying Ventricular Paced Rhythm
Woosun Kang1, Liang D Ge1, Puja Patel2
1Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, USA.
Cureus
|June 30, 2020
Insights
Diagnosing ST-elevation myocardial infarction (STEMI) can be challenging with a ventricular paced rhythm. This case demonstrates successful STEMI diagnosis in a patient with a paced rhythm following bypass surgery.
Area of Science:
- Cardiology
- Clinical Case Reports
Background:
- Severe peripheral vascular disease necessitates surgical intervention, such as femoral-femoral bypass.
- Ventricular paced rhythms can complicate electrocardiogram (ECG) interpretation.
Observation:
- A patient presented with symptoms suggestive of myocardial infarction post-femoral-femoral bypass surgery.
- The patient's electrocardiogram showed a ventricular paced rhythm.
Findings:
- Anterior ST-elevation myocardial infarction (STEMI) was diagnosed despite the ventricular paced rhythm.
- The clinical context was crucial for accurate STEMI diagnosis.
Implications:
- This case underscores the importance of considering STEMI in patients with paced rhythms.
- Clinicians must be vigilant in diagnosing myocardial infarction in complex cardiac rhythms.
- Accurate STEMI diagnosis in paced rhythms requires integrating ECG findings with clinical presentation.
Abstract:
This is a case of a patient diagnosed with anterior ST-elevation myocardial infarction (STEMI) with a ventricular paced rhythm after the patient underwent a femoral-femoral bypass surgery for severe peripheral vascular disease. The case highlights the diagnosis of STEMI in the setting of paced rhythm in the appropriate clinical setting.
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