Acute right coronary artery occlusion can cause ST-segment elevation in anterior precordial leads, mimicking an anterior myocardial infarction.
May mimic anterior STEMI on ECG; leaves open whether ECG criteria or angiography thresholds need revision.
It is rare to observe ST elevation in anterior derivations caused by right ventricular branch occlusion. We described the case of a patient with unstable angina who developed acute right ventricular myocardial infarction with ST-segment elevation in anterior precordial leads (V(1)-V(4)) shortly after coronary angiography. Coronary angiogram revealed total occlusion of the right coronary artery (RCA) proximally to the right ventricular branch. This reminds us that the presence of diffuse ST-segment elevation in the precordial leads could be due to acute RCA occlusion. The differentiation of these two entities is important, as their therapies are quite different.
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Vavuranakis et al. (2006) studied this question.
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