Related Experiment Video

Updated: Nov 18, 2025

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.5K

Acute chest pain with ST-segment elevation in lead V1-V3: when you hear hoofbeats, also look for zebras

Patrizio Pascale1, Anna Giulia Pavon2, Jan Bogaert3

  • 1Cardiology Division, Heart and Vessels Department, Lausanne University Hospital, BH 10-982, Rue de Bugnon 46, 1011, Lausanne, Switzerland. Patrizio.Pascale@chuv.ch.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|February 6, 2021
PubMed

Insights

ST-segment elevation (STE) in anterior leads usually indicates anterior myocardial infarction. However, this pattern can rarely signify isolated right ventricular infarction, a diagnostic pitfall discussed in this study.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Diagnostic Imaging

Background:

  • ST-segment elevation (STE) in anterior precordial leads (V1-V3) is a primary indicator of anterior myocardial infarction.
  • The right ventricular free wall is closely approximated by these anterior leads.
  • Diagnostic errors can occur when STE in these leads is attributed solely to anterior myocardial infarction.

Observation:

  • This study presents a series of 4 patients with ST-segment elevation in anterior leads.
  • These patients exhibited electrocardiographic patterns mimicking anterior myocardial infarction.
  • The underlying cause in these cases was isolated right ventricular infarction.

Findings:

  • Anterior precordial STE can be an uncommon manifestation of isolated right ventricular infarction.
  • Leads V1-V3's proximity to the right ventricle can lead to this diagnostic confusion.
  • Recognizing this pattern is crucial for accurate diagnosis and timely treatment.

Implications:

  • Clinicians must consider right ventricular infarction in the differential diagnosis of anterior STE.
  • Differentiating between anterior and right ventricular infarction is critical for appropriate therapeutic strategies.
  • Awareness of this diagnostic pitfall can improve patient outcomes by preventing delayed or incorrect management.

Keywords:
Anterior ST-elevationElectrocardiogramMyocardial infarctionRight ventricleST-segment

More Related Videos

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.5K
Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm06:18

Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm

Published on: September 17, 2021

1.7K

Related Concept Videos

Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
90
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
91
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
288
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
133
Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
110
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
123