Key result
Proximal RCA occlusion with left-to-right collaterals can present as isolated RV infarction with anterior ST elevation.
Why the study?
Anterior ST-segment elevation typically indicates left anterior descending artery occlusion, and when it occurs with right coronary artery occlusion, concomitant inferior ST-segment elevation is usually present.
Case Report (n=1)
Anterior ST elevation may reflect isolated RV infarction; leaves open refined ECG criteria in collateralized RCA occlusion.
Anterior ST-segment elevation is the classic electrocardiographic feature of anterior left ventricular myocardial infarction due to occlusion of the left anterior descending artery. However, anterior ST-segment elevation has also been described in patients with right coronary artery occlusion, in whom concomitant inferior ST-segment elevation is also typically present. A case of proximal right coronary artery occlusion resulting in anterior ST-segment elevation without inferior ST-segment elevation is reported in this article. It is hypothesized that the inferior left ventricular wall was protected by left-to-right collaterals, as seen on coronary angiography, with resultant isolated right ventricular infarction upon proximal right coronary artery occlusion. In conclusion, this report presents a unique case of an isolated right ventricular infarction resulting in an electrocardiographic pattern mimicking anterior-wall left ventricular infarction.
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Muhammad et al. (2008) conducted a case report in Isolated right ventricular infarction with proximal right coronary artery occlusion (n=1). Proximal right coronary artery occlusion was evaluated on Anterior ST-segment elevation without inferior ST-segment elevation. Proximal right coronary artery occlusion in 1 patient with left-to-right collaterals caused isolated right ventricular infarction with anterior ST-segment elevation.
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