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Angiology
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Article

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

Kamran I. Muhammad, MD* and Samir R. Kapadia, MD

Cleveland Clinic Foundation

* To whom correspondence should be addressed. E-mail: muhammk{at}ccf.org.


  Abstract
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.

First published on April 2, 2008, doi:10.1177/0003319707305464

Angiology 2008;59:622.

A more recent version of this article appeared on October 1, 2008

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