医学
心脏病学
内科学
右冠状动脉
心肌梗塞
经皮冠状动脉介入治疗
ST段
心肌梗死的心电图
ST高程
罪魁祸首
闭塞
心电图
梗塞
急性冠脉综合征
动脉
冠状动脉闭塞
冠状动脉造影
作者
Wayne W Zhong,Matthew Blue,Andrew D. Michaels
出处
期刊:Texas Heart Institute Journal
[Texas Heart Institute Journal]
日期:2019-04-01
卷期号:46 (2): 151-154
被引量:4
标识
DOI:10.14503/thij-17-6581
摘要
Acute right ventricular infarction presenting with ST-segment elevation in the anterior precordial electrocardiographic leads is an unusual event. Anterior ST-segment elevation typically suggests occlusion of the left anterior descending coronary artery. It should be recognized, however, that occlusion of a right coronary artery branch can cause isolated ST-segment elevation in leads V1 and V2 on a standard 12-lead electrocardiogram. We describe the cases of 2 patients who presented with acute chest syndrome with isolated ST-segment elevation in leads V1 and V2. Emergency coronary angiograms revealed that acute thrombotic occlusion of the right ventricular marginal branch of the dominant right coronary artery caused the clinical manifestations in the first patient, whereas occlusion of the proximal nondominant right coronary artery was the culprit lesion in the second patient. Both lesions caused right ventricular myocardial infarction. The patients underwent successful primary percutaneous coronary intervention. These cases illustrate the importance of carefully reviewing angiographic findings to accurately diagnose an acute isolated right ventricular myocardial infarction, which may mimic the electrocardiographic features of an anterior-wall myocardial infarction.
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