Occlusion of a non-dominant RCA can present with anterior ST-segment elevation on ECG, mimicking an LAD occlusion.
Anterior STE may reflect non-dominant RCA occlusion; this Level-5 case leaves open its prevalence and diagnostic impact.
A 51-year-old man presented to the emergency department with acute substernal chest pain. ECG showed ST-segment elevation in the left precordial leads. Coronary angiography demonstrated an occlusion of the right coronary artery (RCA) and no significant stenosis in left anterior descending coronary artery (LAD). The occlusion of a non-dominant RCA may result in anterior ST-segment elevation ECG changes, which could disorient both general and interventional cardiologists.
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Ali et al. (2018) studied this question.
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