Why the study?
ST-segment changes predict the culprit vessel during acute myocardial infarction, but electrocardiographic findings cannot always be explained by vessel anatomy and irrigation territory.
This case highlights that ECG changes in acute myocardial infarction may not always perfectly correlate with the expected coronary anatomy and irrigation territory.
ECG changes in AMI may deviate from expected anatomy; leaves open atypical mechanisms for prospective validation.
Changes of the ST segment are commonly used as predictors of the culprit vessel during an acute myocardial infarction. In case of combined ST elevation in both inferior and anterior leads, these changes can be due to a distal occlusion of a "wrapped" left anterior descending artery (LAD) or a two-vessel disease. Our case of anterior wall myocardial infarction with inferior ST elevation and anterior ST depression shows that electrocardiographic changes during acute myocardial infarction cannot always be explained by logical sequelae of the injury current, vessel anatomy, and their irrigation territory.
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Perčić et al. (2020) studied this question.
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