Acute Inferior ST-Elevation Myocardial Infarction Due to Wraparound Left Anterior Descending Artery

Area of Science:

• Cardiology
• Interventional Cardiology
• Diagnostic Imaging

Background:

• Inferior ST-elevation myocardial infarctions (STEMIs) are typically caused by occlusion of the dominant right coronary artery.
• Accurate diagnosis of STEMI is critical for timely and effective treatment.
• Awareness of atypical presentations is essential for managing life-threatening cardiac events.

Observation:

• A 69-year-old female presented with symptoms suggestive of an inferior STEMI.
• Initial electrocardiogram (ECG) interpretation indicated an inferior STEMI.
• Coronary angiography revealed the culprit lesion was in the left anterior descending artery, not the right coronary artery.

Findings:

• The case demonstrates an unusual cause of inferior STEMI.
• Left anterior descending artery occlusion can present as an inferior STEMI.
• Diagnostic challenges exist in STEMI cases with atypical coronary anatomy or culprit vessel location.

Implications:

• Clinicians must consider rare etiologies when diagnosing STEMI, even with classic ECG findings.
• Advanced imaging like coronary angiography is crucial for definitive diagnosis in ambiguous cases.
• Recognizing exceptional STEMI causes can improve patient outcomes by guiding appropriate interventions.