Anterior ST elevation and electrical storm can be caused by isolated right ventricular infarction due to the occlusion of a nondominant right coronary artery.
May prompt consideration of nondominant RCA occlusion in anterior STE with arrhythmias; hypothesis-generating for isolated RV infarction.
A 42-year-old man emergently presented with chest pain and anterior ST elevation. Refractory ventricular arrhythmias and shock developed rapidly. A coronary angiogram revealed the acute occlusion of a nondominant right coronary artery. After percutaneous coronary intervention, the anterior ST elevation and ventricular arrhythmias resolved. The electrocardiographic pattern was a result of isolated right ventricular infarction that in turn caused profound electrical and hemodynamic instability. We discuss the cause and pathophysiology of this patient's case, and we recommend that interventional and general cardiologists be aware that anterior ST elevation can be caused by the occlusion of a nondominant right coronary artery.
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Franco et al. (2014) studied this question.
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