Key result
Temporary RCA side branch occlusion during PCI produces V1-3 ST-elevation mimicking anterior wall infarction.
Case Report (n=1)
Recognizing the specific ECG pattern of isolated right ventricular infarction (ST-elevation in V4R and V1-3) is crucial to avoid misinterpreting it as an anterior wall infarction during PCI.
ECG interpretation may avert misdiagnosing isolated RV infarction as anterior MI during PCI; case report leaves open prospective validation of criteria.
Isolated right ventricular infarction (RVI) is a rare event. The electrocardiographic (ECG) pattern of RVI, ST-elevation in lead V4R and in anterior chest leads V1-3 is similar to that of a proximal occlusion of a small, nondominant right coronary artery (RCA). The ECG changes may be misinterpreted as signs of infarction of the anterior wall. This paper describes a case of isolated temporary occlusion of the major side branches of the RCA during percutaneous coronary intervention, recognized by angiography findings and typical ECG changes. This case demonstrates how one might avoid wrong decisions even in the catheterization laboratory by putting attention to the anatomical interpretation of the ECG.
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Eskola et al. (2007) conducted a case report in Isolated right ventricular infarction during percutaneous coronary intervention (n=1). Temporary occlusion of major side branches of the right coronary artery during PCI was evaluated on ECG pattern of isolated right ventricular infarction. Isolated temporary occlusion of right coronary artery side branches during PCI produces an ECG pattern of ST-elevation in leads V4R and V1-3, which may mimic anterior wall infarction.
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