Precordial ST-Segment Elevation: Anterior Myocardial Infarction or Something Else?
Daisuke Yakabe1, Takahiro Mori1, Masahiro Araki1
1National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
JACC. Case Reports
|January 15, 2024
Insights
Diagnosing ST-segment elevation requires careful consideration, especially in precordial leads. This case highlights precordial ST-segment elevation in a patient with normal coronary arteries, challenging typical anterior myocardial infarction diagnoses.
Area of Science:
- Cardiology
- Electrocardiography
- Diagnostic Imaging
Background:
- ST-segment elevation on electrocardiogram (ECG) necessitates a broad differential diagnosis.
- Precordial ST-segment elevation often prompts consideration of acute anterior myocardial infarction.
- Accurate diagnosis is critical for timely and appropriate patient management.
Purpose of the Study:
- To present a unique case of precordial ST-segment elevation.
- To discuss the diagnostic challenges posed by ST-segment elevation in the absence of coronary artery disease.
- To emphasize the importance of considering non-ischemic etiologies.
Main Methods:
- Case report presentation.
- Review of electrocardiographic findings.
- Coronary angiography interpretation.
Main Results:
- The patient exhibited significant ST-segment elevation in precordial leads on ECG.
- Coronary angiography revealed normal left coronary arteries.
- The findings indicate a diagnosis other than typical anterior myocardial infarction.
Conclusions:
- Precordial ST-segment elevation can occur in the absence of obstructive coronary artery disease.
- Differential diagnosis for ST-segment elevation must include non-ischemic causes.
- This case underscores the complexity of ECG interpretation in cardiac emergencies.
Abstract:
The differential diagnosis of ST-segment elevation on electrocardiogram is multifaceted. Particularly, in cases of precordial ST-segment elevation, considering anterior myocardial infarction is crucial. Herein, we present a case of precordial ST-segment elevation with normal left coronary arteries.
Related Concept Videos
01:29Electrocardiogram
2.3K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
2.3K
01:17Ischemic Heart Disease: Overview
1.3K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
1.3K
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
159
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
159
01:28Electrocardiogram Fundamentals
600
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
600
01:30Cardiac Action Potential
1.4K
Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
1.4K
01:25Correlation between ECG and Cardiac Cycle
5.4K
The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
5.4K