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Zheng J, Lin J, Shen N, et al. Proximal complete occlusion of right coronary artery presenting with precordial ST-segment elevation: A case report. Medicine (Baltimore). 2016;95(41):e5113doi: 10.1097/MD.0000000000005113.
Zheng, J., Lin, J., Shen, N., & Qu, B. (2016). Proximal complete occlusion of right coronary artery presenting with precordial ST-segment elevation: A case report. Medicine, 95(41), e5113. https://doi.org/10.1097/MD.0000000000005113
Zheng, Jianlei, et al. "Proximal complete occlusion of right coronary artery presenting with precordial ST-segment elevation: A case report." Medicine vol. 95,41 (2016): e5113. doi: https://doi.org/10.1097/MD.0000000000005113
Zheng J, Lin J, Shen N, Qu B. Proximal complete occlusion of right coronary artery presenting with precordial ST-segment elevation: A case report. Medicine (Baltimore). 2016 Oct;95(41):e5113. doi: 10.1097/MD.0000000000005113. PMID: 27741130; PMCID: PMC5072957.
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Medicine (Baltimore). 2016 Oct;95(41):e5113. doi: 10.1097/MD.0000000000005113.

Proximal complete occlusion of right coronary artery presenting with precordial ST-segment elevation: A case report.

Medicine

Jianlei Zheng, Jingyang Lin, Naiji Shen, Baiming Qu

Affiliations

  1. Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou, China.

PMID: 27741130 PMCID: PMC5072957 DOI: 10.1097/MD.0000000000005113

Abstract

BACKGROUND: It is well known that cardiologists empirically judge the culprit lesion of acute ST-segment elevation myocardial infarction (STEMI) according to the corresponding electrocardiographic leads. However, In addition to the obstruction of left anterior descending (LAD) coronary artery, rare cases with the occlusion of proximal right coronary artery (RCA) and/or isolated right ventricular (RV) branch showed the ST-segment elevation in precordial leads V1-V3 as well.

CASE SUMMARY: We reported a patient complaining of acute chest pain and suffering ventricular fibrillation (VF) on admission. The electrocardiogram (ECG) showed mild ST-segment elevation in precordial leads V1-V3 and V4R. Bedside echocardiography displayed normal left ventricular ejection fraction and slight RV dilation. Proximal occlusion of nondominant RCA was confirmed by coronary angiography and urgent percutaneous coronary intervention (PCI) to RCA successfully resolved the chest pain and ST-segment elevation.

CONCLUSION: Undoubtedly, coronary angiography is usually the definite measurement for the diagnosis of culprit lesion. However, bedside echocardiography, ST-segment features in left and right precordial leads, and heart rate will be the additional information for judging ST-segment elevation in precordial leads V1-V3 resulting from occlusion of RCA or LAD.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

References

  1. Int J Cardiol. 2002 Mar;82(3):221-8 - PubMed
  2. Clin Cardiol. 2007 Jul;30(7):331-5 - PubMed
  3. Cardiology. 2002;98(1-2):81-91 - PubMed
  4. J Am Coll Cardiol. 1985 Dec;6(6):1273-9 - PubMed
  5. Catheter Cardiovasc Interv. 2003 Sep;60(1):32-5 - PubMed
  6. J Am Heart Assoc. 2015 Jan 05;4(1):e001399 - PubMed
  7. J Cardiol. 1987 Sep;17(3):455-64 - PubMed
  8. Coron Artery Dis. 1994 Dec;5(12):955-9 - PubMed
  9. Korean Circ J. 2010 Oct;40(10):536-8 - PubMed
  10. Eur Heart J Acute Cardiovasc Care. 2015 Feb;4(1):16-23 - PubMed
  11. Clin Cardiol. 2009 Nov;32(11):E29-32 - PubMed
  12. Am Heart J. 1991 Jan;121(1 Pt 1):51-6 - PubMed
  13. J Clin Diagn Res. 2016 Apr;10(4):OD08-9 - PubMed
  14. Am J Cardiol. 1984 Apr 1;53(8):991-6 - PubMed
  15. J Am Coll Cardiol. 2000 Jan;35(1):144-50 - PubMed
  16. Am Heart J. 1986 Nov;112(5):940-6 - PubMed
  17. Circ J. 2016 Jun 24;80(7):1539-47 - PubMed
  18. J Electrocardiol. 2011 May-Jun;44(3):383-8 - PubMed
  19. Arch Mal Coeur Vaiss. 1992 Jan;85(1):67-75 - PubMed
  20. Cardiol Res Pract. 2015;2015:242686 - PubMed
  21. Heart. 2003 Feb;89(2):E5 - PubMed

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