Available online 23 May 2024

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Anterior and inferior ST elevation on electrocardiography (ECG) in patients with acute myocardial infarction is uncommon. ST-segment elevation due to right ventricular infarction induced by right coronary occlusion may extend from V1 to V3/V4, resembling the pattern of transmural ischemia of the anterior wall of the left ventricle. In addition, a wraparound left anterior descending (LAD) artery can produce ischemia manifesting as ST-segment elevation in the anterior and inferior leads. Our case report reveals dynamic ST-segment changes in acute inferior myocardial infarction, including the appearance of the shark fin ECG pattern, unlike what has been reported before.

Graphical abstract

Anterior and inferior ST elevation on electrocardiography (ECG) in patients with acute myocardial infarction is uncommon. ST-segment elevation due to right ventricular infarction induced by right coronary occlusion may extend from V1 to V3/V4, resembling the pattern of transmural ischemia of the anterior wall of the left ventricle. In addition, a wraparound left anterior descending (LAD) artery can produce ischemia manifesting as ST-segment elevation in the anterior and inferior leads. Our case report reveals dynamic ST-segment changes in acute inferior myocardial infarction, including the appearance of the shark fin ECG pattern, unlike what has been reported before.Download : Download high-res image (178KB)Download : Download full-size image

Section snippetsCase report

A 51-year-old man presented to the emergency department of his local hospital with severe substernal chest pain lasting for 4 h. His medical history included diabetes mellitus and anterior myocardial infarction, for which he underwent emergency revascularization six years prior. The 12‑lead ECG at the local hospital showed complete atrioventricular (AV) block and ST elevation in leads V1 to V3, with pathological Q waves and ST elevation in leads II, III, and aVF and ST depression in leads I and

Discussion

This patient's 12‑lead ECG at a local hospital showed complete AV block and ST elevation in leads V1 to V3, with pathological Q waves and ST elevation in leads II, III, and aVF and ST depression in leads I and aVL, suggesting acute anterior and inferior myocardial infarction. The culprit vessel could be either the RCA or the LAD artery, though RCA occlusion is more common than LAD occlusion [1]. The site of infarct-related artery (IRA) occlusion is most often the proximal RCA and mid- or distal

Author contributions

SY wrote the manuscript and performed the literature search. CW and HZ performed the collection of data. JW guaranteed of the integrity of the entire study. All authors have read and approved the manuscript reviewed the literature.

Author statement

The work described has not been submitted elsewhere for publication, in whole or in part, and all the authors listed have approved the manuscript and have no conflict of interest.

Ethics approval

This case report has been conducted according to the standards of the Declaration of Helsinki.

Funding

This report was funded by the Natural Science Foundation of Shandong Province [NO. ZR2020QH104].

CRediT authorship contribution statement

Shoujuan Yang: Writing – original draft. Chunfang Wang: Data curation. Haitao Zhang: Formal analysis. Jian Wang: Writing – review & editing.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

We thank the patient in this report.

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© 2024 Published by Elsevier Inc.