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Updated: Aug 1, 2025

Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Inferior and precordial ST-segment elevation myocardial infarction due to large wrap-around left anterior descending
Hiroto Tamura1, Yohei Tobetto1, Akiho Seno1
1Department of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan.
Insights
A rare wrap-around left anterior descending artery (LAD) occlusion caused simultaneous inferior and precordial ST-segment elevation myocardial infarction. Prompt reperfusion saved the patient, highlighting the need for early intervention in such severe cases.
Area of Science:
- Cardiology
- Interventional Cardiology
- Diagnostic Electrocardiography
Background:
- Left anterior descending artery (LAD) occlusion typically causes precordial ST-segment elevation.
- Wrap-around LAD anatomy is rare but perfuses a significant myocardial territory, including anterior and inferior walls.
Abstract:
Left anterior descending artery (LAD) occlusion normally develops into precordial ST-segment elevation; however, we describe a case of a 50-year-old man with inferior and precordial ST-segment elevation myocardial infarction that resulted from proximal occlusion of the wrap-around LAD perfusing the anterior and inferior wall. We performed early and prompt reperfusion and were able to save the patient without any complications. A wrap-around LAD perfuses a large myocardial area; therefore, this type of coronary occlusion causes severe myocardial damage and has a poor prognosis. The rates of new-onset heart failure and heart failure rehospitalization are also high. Simultaneous inferior and precordial ST-segment elevations on electrocardiography suggest acute myocardial infarction with a wrap-around LAD lesion, which requires prompt revascularization. More careful medications for heart failure and follow-up should be also required even after discharge in such case.
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