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Acute inferior occlusion myocardial infarction with a solitary ST-elevation in lead III: A case report

Qin Zhang1, Yao Zhao1, Xinmiao Huang1

  • 1Department of Cardiovasology, Changhai Hospital, Naval Military Medical University, 168 Changhai Road, Shanghai 200433, China.

Journal of Electrocardiology
|March 14, 2022
PubMed

Insights

The Aslanger pattern identifies acute coronary occlusion myocardial infarction (OMI) without typical ST-segment elevation (STE) on ECG, highlighting limitations in current STEMI criteria for acute coronary occlusion (ACO) diagnosis.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Acute Coronary Syndromes

Background:

  • ST-segment elevation myocardial infarction (STEMI) diagnosis relies on contiguous ST-segment elevation (STE) on electrocardiography (ECG).
  • Current STEMI criteria may miss acute coronary occlusion (ACO) cases.
  • The Aslanger pattern is an ECG finding suggestive of acute inferior occlusion myocardial infarction (OMI) with multi-vessel disease, even without contiguous STE.

Observation:

  • A case presented with an ECG showing STE only in lead III, initially not meeting STEMI criteria.
  • Despite atypical ECG findings, acute inferior OMI was suspected.
  • Coronary angiography revealed proximal right coronary artery thrombosis and significant stenosis in other coronary arteries.

Findings:

  • The Aslanger pattern can indicate inferior OMI with multi-vessel coronary artery disease.
  • ECG findings may not always align with the traditional STEMI definition in cases of acute coronary occlusion.
  • Prompt recognition of atypical ECG patterns is vital for diagnosing OMI.

Implications:

  • Clinicians must be aware of STEMI criteria limitations to avoid diagnostic delays.
  • Recognizing patterns like the Aslanger pattern can improve the detection of OMI.
  • Timely intervention in OMI, regardless of classic ECG findings, is critical for patient outcomes.

Keywords:
Acute inferior occlusion myocardial infarctionElectrocardiogramST-segment elevationVectorcardiography

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