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Chest pain showing precordial ST-segment elevation in a 96-year-old woman with right coronary artery occlusion: A

Hao-Yu Wu1, Gong Cheng1, Yi-Wei Cao2

  • 1Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China.

World Journal of Clinical Cases
|March 22, 2021
PubMed

Insights

Right coronary artery (RCA) occlusion can cause ST-segment elevation in precordial leads, a rare finding. This case highlights the importance of considering nondominant RCA occlusion in diagnosing acute myocardial infarction.

Area of Science:

  • Cardiology
  • Diagnostic Electrocardiography
  • Interventional Cardiology

Background:

  • Right coronary artery (RCA) occlusion typically presents with inferior ST-segment elevation on ECG.
  • ST-segment elevation in precordial leads is an unusual presentation for RCA occlusion.

Observation:

  • An elderly woman presented with acute chest pain and dynamic precordial ST-segment elevation.
  • Coronary angiography revealed acute total occlusion of the proximal nondominant RCA.

Findings:

  • Percutaneous coronary intervention successfully treated the RCA occlusion.
  • Post-procedure ECG showed resolution of precordial ST-segment elevation.
  • Diagnosis of acute isolated right ventricular infarction due to proximal nondominant RCA occlusion was confirmed.

Implications:

  • Cardiologists must recognize that precordial ST-segment elevation can indicate nondominant RCA occlusion.
  • Timely diagnosis and intervention are crucial for managing myocardial infarction.
  • This case expands the understanding of ECG manifestations in coronary artery disease.
Abstract

Keywords:
Case reportChest painElectrocardiogramIsolated right ventricular infarctionPrecordial ST-segment elevationRight coronary artery occlusion

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