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13-08-2018 | Heart Beat | Uitgave 10/2018 Open Access

Netherlands Heart Journal 10/2018

Inferior acute myocardial infarction with anterior ST-segment elevations

Netherlands Heart Journal > Uitgave 10/2018
L. J. Bouhuijzen, M. G. Stoel
A 56-year-old woman presented with chest pain for the past 6 h and a clinical picture consistent with an ST-elevation myocardial infarction. A 12-lead electrocardiogram is shown in Fig. 1. Immediate coronary angiography revealed occlusion of a non-dominant right coronary artery (RCA). Successful intervention with a drug-eluting stent was performed. The left-sided coronary arteries showed no significant stenosis.
Acute myocardial infarction with ST-segment elevation in both anterior and inferior leads is usually caused by occlusion of a wrap-around left anterior descending or proximal RCA occlusion [1]. Several mechanisms have been proposed for anterior ST-segment elevation in inferior infarction [2]. In this case, we hypothesised that acute ischaemic right ventricular dilation causes anti-clockwise rotation in the horizontal plane, resulting in ST elevation in all precordial leads. Surprisingly, the presence of concomitant precordial ST elevation is associated with smaller infarct size. This is probably explained by an absence of posterior infarction, which would result in precordial ST-segment depression [3].

Conflict of interest

L.J. Bouhuijzen and M.G. Stoel declare that they have no competing interests.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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