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Angiology
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Anterior ST-Segment Elevation With Right Coronary Artery Occlusion: A Unique Case of Isolated Right Ventricular Infarction

Kamran I. Muhammad, MD

Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, muhammk{at}ccf.org

Samir R. Kapadia, MD

Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio

Anterior ST-segment elevation is the classic electrocardiographic feature of anterior left ventricular myocardial infarction due to occlusion of the left anterior descending artery. However, anterior ST-segment elevation has also been described in patients with right coronary artery occlusion, in whom concomitant inferior ST-segment elevation is also typically present. A case of proximal right coronary artery occlusion resulting in anterior ST-segment elevation without inferior ST-segment elevation is reported in this article. It is hypothesized that the inferior left ventricular wall was protected by left-to-right collaterals, as seen on coronary angiography, with resultant isolated right ventricular infarction upon proximal right coronary artery occlusion. In conclusion, this report presents a unique case of an isolated right ventricular infarction resulting in an electrocardiographic pattern mimicking anterior-wall left ventricular infarction.

Key Words: right ventricular infarction • collateralization • percutaneous coronary intervention • electrocardiography

This version was published on October 1, 2008

Angiology, Vol. 59, No. 5, 622-624 (2008)
DOI: 10.1177/0003319707305464
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