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Acute proximal left anterior descending coronary artery occlusion presenting with Normal ECG: A case report

Yuecheng Hu1, Dongxia Jin1, Chunwei Liu1

  • 1Department of Cardiology, Tianjin Chest Hospital, Tianjin University, Chest Clinical Medical College of Tianjin Medical University, Tianjin, China.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|September 5, 2022
PubMed

Insights

A middle-aged male experienced acute anterior wall myocardial infarction despite normal electrocardiogram (ECG) findings within six hours of admission. This case challenges existing theories, highlighting diagnostic complexities in myocardial infarction.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Diagnostic Imaging

Background:

  • Acute anterior wall myocardial infarction (MI) is a critical cardiovascular event.
  • Electrocardiogram (ECG) is a primary diagnostic tool for MI.
  • Typical ECG changes may be absent in early stages or atypical presentations of MI.

Observation:

  • A middle-aged male presented with symptoms consistent with myocardial infarction.
  • Coronary angiography (CAG) confirmed acute anterior wall myocardial infarction.
  • However, the patient's ECG showed no significant QRS wave or ST-T changes within 6 hours of admission.

Findings:

  • The diagnostic presentation was atypical, with a discrepancy between clinical/angiographic findings and ECG results.
  • This case highlights potential limitations in relying solely on early ECG for diagnosing myocardial infarction.

Implications:

  • Further research is needed to understand atypical presentations of myocardial infarction.
  • This case may prompt a review of diagnostic protocols for myocardial infarction, especially in the early hours.
  • Clinicians should consider a broader range of diagnostic tools when ECG is non-diagnostic for suspected myocardial infarction.

Keywords:
basicclinical, ventricular tachycardia/fibrillationnon-invasive techniques - T-wave alternans

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